Adolescent and young adult long-acting reversible contraception post-insertion visit attendance before and after COVID-19

Amanda E. Bryson; Carly E. Milliren; Claudia Borzutzky; Sarah A. Golub; Sarah A. B. Pitts; Amy D. DiVasta

doi:10.1515/ijamh-2023-0134

Article

Adolescent and young adult long-acting reversible contraception post-insertion visit attendance before and after COVID-19

Amanda E. Bryson , Carly E. Milliren , Claudia Borzutzky , Sarah A. Golub , Sarah A. B. Pitts and Amy D. DiVasta

Published/Copyright: November 20, 2023

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From the journal International Journal of Adolescent Medicine and Health Volume 36 Issue 1

Abstract

Objectives

Widespread use of telemedicine for contraceptive care, including long-acting reversible contraception (LARC), was adopted in the United States in response to the COVID-19 pandemic. Given the rapid implementation of these services, little is known about the use of telemedicine for adolescent and young adult (AYA) contraceptive care. This study examined the routine use of telemedicine for LARC post-insertion care by comparing visit attendance between AYAs receiving LARC before and after the COVID-19 pandemic onset.

Methods

This analysis included LARC insertions 3/1/19–11/30/19 (pre-pandemic onset cohort) and 4/1/20–12/31/20 (post-pandemic onset cohort) from three Adolescent Medicine subspecialty clinics in the United States. De-identified data were collected via review of the electronic health record. Descriptive statistics, χ² tests, and t-tests described and compared groups. Adjusted logistic regression models examined factors associated with attending a post-insertion visit and attending this visit via telemedicine.

Results

This analysis included 525 LARC insertions (279 pre- and 246 post-pandemic onset). The proportion of AYAs attending a post-insertion visit increased after the COVID-19 pandemic onset (pre 30 % vs. post 46 %; p≤0.001). Adjusted models revealed that the post-pandemic onset cohort was nearly twice as likely to attend a post-insertion visit as the pre-pandemic onset cohort (OR=1.90; 95 % CI=1.68–2.15). Of those attending this visit in the post-pandemic onset cohort (n=112), 42 % utilized telemedicine.

Conclusions

AYAs were more likely to attend post-insertion visits after the COVID-19 pandemic onset than before. Telemedicine may have influenced this change in visit attendance.

Keywords: long-acting reversible contraception; adolescent; young adult; telemedicine

Corresponding author: Amanda E. Bryson, MD, MPH, Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA, E-mail: amanda.bryson@ucsf.edu

Sarah A. B. Pitts and Amy D. DiVasta are co-senior authors. Current address: Amanda E. Bryson, Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, CA, USACurrent address: Claudia Borzutzky, Planned Parenthood Los Angeles, Los Angeles, CA, USA

Funding source: 2020 North American Society for Pediatric and Adolescent Gynecology Fellows Research Grant

Funding source: Investigator-Initiated Studies Program of Organon

Funding source: Health Resources and Services Administration of the US Department of Health and Human Services

Award Identifier / Grant number: T71MC00009, T71MC30799, and 5T71 MC242101000

Acknowledgments

Thank you to those who helped with data collection for the Adolescent Medicine LARC Collaborative, including Grace Berg, Julian Garcia, Taraneh Shafii, MD, MPH, and Yolanda Evans, MD, MPH.

Research ethics: The local Institutional Review Board deemed the study exempt from review.
Informed consent: Informed consent was not indicated given the use of electronic health record review for data collection for this study.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors receive support from Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) as part of a LEAH training grants (grant number MCHB T71MC00009, T71MC30799 [to A.B., S.P., A.D.], T71MC30799 [to C.B.], and 5T71 MC242101000 [to S.G.]). The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement by, NASPAG, Organon, HRSA, HHS, or the US Government. None of the funders participated in study design, data collection, data analysis, data interpretation, or in the writing of the manuscript. None of the authors received an honorarium, grant, or other form of payment to produce the manuscript.
Research funding: Supported by the 2020 North American Society for Pediatric and Adolescent Gynecology (NASPAG) Fellows Research Grant (to A.B., S.P., A.D., C.M.) and the Investigator-Initiated Studies Program of Organon (to S.P., A.D., C.M., S.G., C.B.).

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Received: 2023-08-24

Accepted: 2023-11-07

Published Online: 2023-11-20

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Articles in the same Issue

https://doi.org/10.1515/ijamh-2023-0134

Keywords for this article

long-acting reversible contraception; adolescent; young adult; telemedicine