Background: Long-acting reversible contraception (LARC) has long been regarded as highly effective and safe. However, access is limited and lengthy when specialty referrals are required. Objectives: To integrate LARC services into an urban internal medicine primary care practice to decrease wait time for LARC procedures. Design/methods: This pre–post with control group study took place at two large urban academic primary care practices (Practices A and B) and included patients ages 18 to 45 years assigned female sex at birth. Pre-implementation baseline data were collected retrospectively from 2019 to 2020 by identifying subjects who requested LARC insertion or removal via their primary care practice and were referred to Obstetrics and Gynecology (Ob/Gyn) for the procedure. Wait time was noted from time of initial request in the medical record to time of procedure. Practice A developed an integrated primary care LARC program in which one of their LARC-trained providers began offering these procedures within their own practice. All other providers within the practice were educated on how to counsel patients about the devices and procedures. Practice B did not have an in-house LARC provider and continued referring patients to Ob/Gyn. Post-implementation data were collected prospectively 2021–2022. Results: Ninety-one patients in Practice A experienced a significant decrease in wait time (87 vs 21 days, p < 0.001) over the observation period, with a majority undergoing procedures on their first visit with the in-house LARC provider. Wait time for the 54 patients in Practice B remained unchanged (57 vs 47 days, p = .59), often requiring multiple specialty visits. Conclusion: Integrating LARC services into a primary care internal medicine practice can significantly reduce wait times for these procedures with the potential to contribute to increased reproductive and menstrual autonomy.

01 Jan 2019·Texas medicine

Leveraging LARCs: Long-Acting Reversible Contraceptives Part of Texas' Solution to Unwanted Pregnancies, Maternal Deaths.

Article

Author: Price, Sean

Today LARCs are one of the safest and most-effective types of reversible birth control, but their reputation took a huge hit in the 1970s thanks to the Dalkon Shield intrauterine device (IUD). Memories persist of news reports about the shield's many defects. This mistrust of LARCs - along with other obstacles to their wider use - hamper progress toward a wider goal for Texas medicine: improving maternal health and reducing maternal deaths across the state.

11 Aug 2016·Global Health: Science and PracticeQ3 · MEDICINE

Increasing Uptake of Long-Acting Reversible Contraceptives in Cambodia Through a Voucher Program: Evidence From a Difference-in-Differences Analysis

Q3 · MEDICINE

ArticleOA

Author: Veasnakiry, Lo ; Bellows, Ben ; Rathavy, Tung ; Bajracharya, Ashish

OBJECTIVEThis article evaluates the use of modern contraceptives among poor women exposed to a family planning voucher program in Cambodia, with a particular focus on the uptake of long-acting reversible contraceptives (LARCs).METHODSWe used a quasi-experimental study design and data from before-and-after intervention cross-sectional household surveys (conducted in 2011 and 2013) in 9 voucher program districts in Kampong Thom, Kampot, and Prey Veng provinces, as well as 9 comparison districts in neighboring provinces, to evaluate changes in use of modern contraceptives and particularly LARCs in the 12 months preceding each survey. Survey participants in the analytical sample were currently married, non-pregnant women ages 18 to 45 years (N = 1,936 at baseline; N = 1,986 at endline). Difference-in-differences (DID) analyses were used to examine the impact of the family planning voucher.RESULTSModern contraceptive use increased in both intervention and control areas between baseline and endline: in intervention areas, from 22.4% to 31.6%, and in control areas, from 25.2% to 31.0%. LARC use also increased significantly between baseline and endline in both intervention (from 1.4% to 6.7%) and control (from 1.9% to 3.5%) areas, but the increase in LARC use was 3.7 percentage points greater in the intervention area than in the control area (P = .002), suggesting a positive and significant association of the voucher program with LARC use. The greatest increases occurred among the poorest and least educated women.CONCLUSIONA family planning voucher program can increase access to and use of more effective long-acting methods among the poor by reducing financial and information barriers.

100 Deals associated with Long-acting controlled formulations of contraceptives(DelsiTech)

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Indication	Highest Phase	Country/Location	Organization	Date
Contraception	Preclinical	FI	DelSiTech Oy	28 Jan 2023

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