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Predictors of non-use of intrauterine contraception among women aged 18–49 years in a general practice setting in the UK

Authors Walker SH, Newton VL, Hoggart L, Parker MJ

Received 11 July 2016

Accepted for publication 11 September 2016

Published 21 October 2016 Volume 2016:7 Pages 155—160


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Igal Wolman

Video abstract presented by Susan H Walker.

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Susan H Walker,1 Victoria L Newton,2 Lesley Hoggart,3 Mike J Parker4

1Faculty of Health, Social Care & Education, Anglia Ruskin University, Chelmsford, 2Faculty of Health & Social Care, The Open University, Milton Keynes, 3School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, 4Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, UK

Objectives: Our research examined the barriers to the uptake of intrauterine contraception (IUC) by women in a general practice (GP) setting in the UK. This study reports predictors of non-use of IUC in this context.
Design: We used a mixed method Qual/Quant approach in which the initial qualitative research provides a framework for subsequent larger quantitative surveys. Utilizing findings derived from 30 qualitative interviews, a quantitative survey was developed and distributed to a pragmatic sample of 1,195 women, aged 18–49 years, who were recruited through 32 participating GP practices in an area of England, UK. Outcome measures were percentage of attributes or responses in the sample and use or non-use of IUC. Results were analyzed using descriptive statistical analysis and binary logistic regression, using use/non-use as a binary response variable.
Results: Attitudinal variables, which were the strongest predictors of non-use of IUC, were an adverse opinion on long-acting aspect of IUC (odds ratio [OR]=8.34), disliking the thought of IUC inside the body (OR=3.138), concerns about IUC causing difficulties becoming pregnant in the future (OR=2.587), concerns about womb damage (OR=2.224), having heard adverse opinions about levonorgestrel-releasing intrauterine system (Mirena®) (OR=2.551), having an adverse opinion of having light, irregular periods (OR=2.382) and, having an adverse opinion of having no periods (OR=2.018).
Conclusion: Concerns about the long-acting nature of IUC and persisting concerns about the safety of IUC may act as barriers to its use. Information for women, tailored to specifically address these concerns, is needed.
Implications: Clinicians should provide more reassurance and information to potential users of IUC to increase their confidence about the possibility of removing IUC early or on request. They should also specifically seek to alleviate concerns about internal damage, damage to the womb, or damage to future fertility from using the methods.

Keywords: intrauterine device, intrauterine contraception, intrauterine system, general ­practice, UK

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