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Twelve-month discontinuation of etonogestrel implant in an outpatient pediatric setting
The etonogestrel (ENG) contraceptive implant is the most effective reversible contraceptive method. Uptake remains limited in adolescents, a population at high risk for unintended pregnancy. The objectives of this study were to determine the 12-month discontinuation rate of the ENG implant among ado...
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| Published in: | Contraception (Stoneham) 2016-07, Vol.94 (1), p.81-86 |
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| container_title | Contraception (Stoneham) |
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| creator | Berlan, Elise Mizraji, Kelly Bonny, Andrea E. |
| description | The etonogestrel (ENG) contraceptive implant is the most effective reversible contraceptive method. Uptake remains limited in adolescents, a population at high risk for unintended pregnancy. The objectives of this study were to determine the 12-month discontinuation rate of the ENG implant among adolescents in an outpatient setting and to characterize risk factors for discontinuation.
A retrospective chart review identified adolescent females aged 12 to 22years who received the ENG implant in one pediatric institution between January 1, 2011, and April 15, 2014. Patients were categorized into ENG discontinuers (removed prior to 12months) and ENG continuers (continued for ≥12months). Associations between demographic, clinical and postplacement characteristics with ENG discontinuation category were assessed with t tests, χ2/Fisher's Exact Tests and backwards stepwise logistic regression.
Of the 750 patients who had an ENG implant inserted, 77 (10.3%) had the device removed prior to 12months of use. The mean length of implant use for those who discontinued was 7.5months. Problematic bleeding was the most commonly cited reason for discontinuation. Older age at time of insertion, history of pregnancy and ≥1 medical visit for implant concerns (not including removal) were independently predictive (p |
| doi_str_mv | 10.1016/j.contraception.2016.02.030 |
| format | article |
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A retrospective chart review identified adolescent females aged 12 to 22years who received the ENG implant in one pediatric institution between January 1, 2011, and April 15, 2014. Patients were categorized into ENG discontinuers (removed prior to 12months) and ENG continuers (continued for ≥12months). Associations between demographic, clinical and postplacement characteristics with ENG discontinuation category were assessed with t tests, χ2/Fisher's Exact Tests and backwards stepwise logistic regression.
Of the 750 patients who had an ENG implant inserted, 77 (10.3%) had the device removed prior to 12months of use. The mean length of implant use for those who discontinued was 7.5months. Problematic bleeding was the most commonly cited reason for discontinuation. Older age at time of insertion, history of pregnancy and ≥1 medical visit for implant concerns (not including removal) were independently predictive (p<.01) of method discontinuation.
The vast majority of adolescents continued the ENG implant at 12months, making it an excellent contraceptive choice for adolescents within the outpatient pediatric setting. Greater efforts should be made to increase its use by pediatric providers.
The ENG implant is an excellent contraceptive option for adolescents in the outpatient pediatric setting.</description><identifier>ISSN: 0010-7824</identifier><identifier>EISSN: 1879-0518</identifier><identifier>DOI: 10.1016/j.contraception.2016.02.030</identifier><identifier>PMID: 26948183</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adolescents ; Child ; Contraception ; Contraception - utilization ; Contraceptive Agents, Female - administration & dosage ; Contraceptive Agents, Female - therapeutic use ; Desogestrel - administration & dosage ; Desogestrel - therapeutic use ; Device Removal - statistics & numerical data ; Etonogestrel ; Female ; Hemorrhage - etiology ; Humans ; Implant ; Logistic Models ; Multivariate Analysis ; Outpatients ; Pediatric ; Pediatrician ; Pregnancy ; Pregnancy in Adolescence - prevention & control ; Retrospective Studies ; Time Factors ; United States ; Young Adult</subject><ispartof>Contraception (Stoneham), 2016-07, Vol.94 (1), p.81-86</ispartof><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c383t-1e8ee61a7b286aaa86890ecba89c8c09329ed30652576d589ec02a36b078df433</citedby><cites>FETCH-LOGICAL-c383t-1e8ee61a7b286aaa86890ecba89c8c09329ed30652576d589ec02a36b078df433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26948183$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Berlan, Elise</creatorcontrib><creatorcontrib>Mizraji, Kelly</creatorcontrib><creatorcontrib>Bonny, Andrea E.</creatorcontrib><title>Twelve-month discontinuation of etonogestrel implant in an outpatient pediatric setting</title><title>Contraception (Stoneham)</title><addtitle>Contraception</addtitle><description>The etonogestrel (ENG) contraceptive implant is the most effective reversible contraceptive method. Uptake remains limited in adolescents, a population at high risk for unintended pregnancy. The objectives of this study were to determine the 12-month discontinuation rate of the ENG implant among adolescents in an outpatient setting and to characterize risk factors for discontinuation.
A retrospective chart review identified adolescent females aged 12 to 22years who received the ENG implant in one pediatric institution between January 1, 2011, and April 15, 2014. Patients were categorized into ENG discontinuers (removed prior to 12months) and ENG continuers (continued for ≥12months). Associations between demographic, clinical and postplacement characteristics with ENG discontinuation category were assessed with t tests, χ2/Fisher's Exact Tests and backwards stepwise logistic regression.
Of the 750 patients who had an ENG implant inserted, 77 (10.3%) had the device removed prior to 12months of use. The mean length of implant use for those who discontinued was 7.5months. Problematic bleeding was the most commonly cited reason for discontinuation. Older age at time of insertion, history of pregnancy and ≥1 medical visit for implant concerns (not including removal) were independently predictive (p<.01) of method discontinuation.
The vast majority of adolescents continued the ENG implant at 12months, making it an excellent contraceptive choice for adolescents within the outpatient pediatric setting. Greater efforts should be made to increase its use by pediatric providers.
The ENG implant is an excellent contraceptive option for adolescents in the outpatient pediatric setting.</description><subject>Adolescent</subject><subject>Adolescents</subject><subject>Child</subject><subject>Contraception</subject><subject>Contraception - utilization</subject><subject>Contraceptive Agents, Female - administration & dosage</subject><subject>Contraceptive Agents, Female - therapeutic use</subject><subject>Desogestrel - administration & dosage</subject><subject>Desogestrel - therapeutic use</subject><subject>Device Removal - statistics & numerical data</subject><subject>Etonogestrel</subject><subject>Female</subject><subject>Hemorrhage - etiology</subject><subject>Humans</subject><subject>Implant</subject><subject>Logistic Models</subject><subject>Multivariate Analysis</subject><subject>Outpatients</subject><subject>Pediatric</subject><subject>Pediatrician</subject><subject>Pregnancy</subject><subject>Pregnancy in Adolescence - prevention & control</subject><subject>Retrospective Studies</subject><subject>Time Factors</subject><subject>United States</subject><subject>Young Adult</subject><issn>0010-7824</issn><issn>1879-0518</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNqNkE1LxDAQhoMoun78BSl48dI6SbZNgicRv0DwongM2XRWs7RNTVLFf2-WVcGbp4GZ931n5iHkhEJFgTZnq8r6IQVjcUzODxXLzQpYBRy2yIxKoUqoqdwmMwAKpZBsvkf2Y1wBgFC12CV7rFFzSSWfkefHD-zesexz5GvRurjOdsNk1tGFXxaY_OBfMKaAXeH6sTNDKtxQmDyd0ph1mBsjts6k4GwRMWX_yyHZWZou4tF3PSBP11ePl7fl_cPN3eXFfWm55KmkKBEbasSCycYYIxupAO3CSGWlBcWZwpZDU7NaNG0tFVpghjcLELJdzjk_IKeb3DH4tymfqfv8A3b5TPRT1FQoVnMhmMzS843UBh9jwKUeg-tN-NQU9JqsXuk_ZPWarAamM9nsPv5eNC16bH-9Pyiz4GojwPzuu8Ogo81sbCYT0CbdevevRV8l2ZQE</recordid><startdate>201607</startdate><enddate>201607</enddate><creator>Berlan, Elise</creator><creator>Mizraji, Kelly</creator><creator>Bonny, Andrea E.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201607</creationdate><title>Twelve-month discontinuation of etonogestrel implant in an outpatient pediatric setting</title><author>Berlan, Elise ; Mizraji, Kelly ; Bonny, Andrea E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c383t-1e8ee61a7b286aaa86890ecba89c8c09329ed30652576d589ec02a36b078df433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adolescents</topic><topic>Child</topic><topic>Contraception</topic><topic>Contraception - utilization</topic><topic>Contraceptive Agents, Female - administration & dosage</topic><topic>Contraceptive Agents, Female - therapeutic use</topic><topic>Desogestrel - administration & dosage</topic><topic>Desogestrel - therapeutic use</topic><topic>Device Removal - statistics & numerical data</topic><topic>Etonogestrel</topic><topic>Female</topic><topic>Hemorrhage - etiology</topic><topic>Humans</topic><topic>Implant</topic><topic>Logistic Models</topic><topic>Multivariate Analysis</topic><topic>Outpatients</topic><topic>Pediatric</topic><topic>Pediatrician</topic><topic>Pregnancy</topic><topic>Pregnancy in Adolescence - prevention & control</topic><topic>Retrospective Studies</topic><topic>Time Factors</topic><topic>United States</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Berlan, Elise</creatorcontrib><creatorcontrib>Mizraji, Kelly</creatorcontrib><creatorcontrib>Bonny, Andrea E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Contraception (Stoneham)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Berlan, Elise</au><au>Mizraji, Kelly</au><au>Bonny, Andrea E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Twelve-month discontinuation of etonogestrel implant in an outpatient pediatric setting</atitle><jtitle>Contraception (Stoneham)</jtitle><addtitle>Contraception</addtitle><date>2016-07</date><risdate>2016</risdate><volume>94</volume><issue>1</issue><spage>81</spage><epage>86</epage><pages>81-86</pages><issn>0010-7824</issn><eissn>1879-0518</eissn><abstract>The etonogestrel (ENG) contraceptive implant is the most effective reversible contraceptive method. Uptake remains limited in adolescents, a population at high risk for unintended pregnancy. The objectives of this study were to determine the 12-month discontinuation rate of the ENG implant among adolescents in an outpatient setting and to characterize risk factors for discontinuation.
A retrospective chart review identified adolescent females aged 12 to 22years who received the ENG implant in one pediatric institution between January 1, 2011, and April 15, 2014. Patients were categorized into ENG discontinuers (removed prior to 12months) and ENG continuers (continued for ≥12months). Associations between demographic, clinical and postplacement characteristics with ENG discontinuation category were assessed with t tests, χ2/Fisher's Exact Tests and backwards stepwise logistic regression.
Of the 750 patients who had an ENG implant inserted, 77 (10.3%) had the device removed prior to 12months of use. The mean length of implant use for those who discontinued was 7.5months. Problematic bleeding was the most commonly cited reason for discontinuation. Older age at time of insertion, history of pregnancy and ≥1 medical visit for implant concerns (not including removal) were independently predictive (p<.01) of method discontinuation.
The vast majority of adolescents continued the ENG implant at 12months, making it an excellent contraceptive choice for adolescents within the outpatient pediatric setting. Greater efforts should be made to increase its use by pediatric providers.
The ENG implant is an excellent contraceptive option for adolescents in the outpatient pediatric setting.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26948183</pmid><doi>10.1016/j.contraception.2016.02.030</doi><tpages>6</tpages></addata></record> |
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| language | eng |
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| source | ScienceDirect Freedom Collection 2022-2024 |
| subjects | Adolescent Adolescents Child Contraception Contraception - utilization Contraceptive Agents, Female - administration & dosage Contraceptive Agents, Female - therapeutic use Desogestrel - administration & dosage Desogestrel - therapeutic use Device Removal - statistics & numerical data Etonogestrel Female Hemorrhage - etiology Humans Implant Logistic Models Multivariate Analysis Outpatients Pediatric Pediatrician Pregnancy Pregnancy in Adolescence - prevention & control Retrospective Studies Time Factors United States Young Adult |
| title | Twelve-month discontinuation of etonogestrel implant in an outpatient pediatric setting |
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