BACKGROUND AND OBJECTIVES: Intrauterine devices (IUDs) are recommended as first-line choices for both nulliparous and parous adolescents by the American College of Obstetrics and Gynecology (ACOG). This study describes use of IUDs and knowledge regarding IUD use in adolescents in South Carolina family medicine residency programs. METHODS: Faculty and residents in South Carolina Area Health Education Consortium (SC AHEC) Family Medicine Residency Programs received an anonymous survey including questions about current use of IUDs and scenarios where they were asked whether they would recommend an IUD. Proportions were compared using chi-square or Fisher's Exact Test. Modified Wald method was utilized to calculate 95% confidence intervals. RESULTS: The survey response rate was 53.8% (n=133). Most respondents (78%) prescribed IUDs and 42% inserted them, but ≥ 90% reported only prescribing or inserting ≤ 10 yearly. In scenarios where IUD recommendation was appropriate, only 27% (95% CI: 20.2-35.2) recommended IUDs for a sexually active adolescent, whereas 60% (95% CI: 51.7-68.1) recommended use for a postpartum adolescent. For similar scenarios in non-adolescents, a statistically significant higher proportion recommended IUDs, with 50% (95% CI: 42.0-58.7) recommending use in a 21-year-old nulliparous woman and 77% (95% CI: 68.8-83.1) in a breast-feeding mother. Women were more likely to recommend IUD use than men in non-adolescents, but not adolescents. There was no difference in recommendations by level of training. CONCLUSIONS: Knowledge regarding IUD use in nulliparous women and adolescents is limited in this sample of family physicians. Increasing appropriate IUD recommendations may increase IUD use and improve contraceptive counseling for adolescents.
BACKGROUND AND OBJECTIVES: Intrauterine devices (IUDs) are recommended as first-line choices for both nulliparous and parous adolescents by the American College of Obstetrics and Gynecology (ACOG). This study describes use of IUDs and knowledge regarding IUD use in adolescents in South Carolina family medicine residency programs. METHODS: Faculty and residents in South Carolina Area Health Education Consortium (SC AHEC) Family Medicine Residency Programs received an anonymous survey including questions about current use of IUDs and scenarios where they were asked whether they would recommend an IUD. Proportions were compared using chi-square or Fisher's Exact Test. Modified Wald method was utilized to calculate 95% confidence intervals. RESULTS: The survey response rate was 53.8% (n=133). Most respondents (78%) prescribed IUDs and 42% inserted them, but ≥ 90% reported only prescribing or inserting ≤ 10 yearly. In scenarios where IUD recommendation was appropriate, only 27% (95% CI: 20.2-35.2) recommended IUDs for a sexually active adolescent, whereas 60% (95% CI: 51.7-68.1) recommended use for a postpartum adolescent. For similar scenarios in non-adolescents, a statistically significant higher proportion recommended IUDs, with 50% (95% CI: 42.0-58.7) recommending use in a 21-year-old nulliparous woman and 77% (95% CI: 68.8-83.1) in a breast-feeding mother. Women were more likely to recommend IUD use than men in non-adolescents, but not adolescents. There was no difference in recommendations by level of training. CONCLUSIONS: Knowledge regarding IUD use in nulliparous women and adolescents is limited in this sample of family physicians. Increasing appropriate IUD recommendations may increase IUD use and improve contraceptive counseling for adolescents.