Provider Attitudes and Practices Regarding Intrauterine System (IUS) Insertion in Adolescents With and Without Bleeding Disorders for Management of Heavy Menstrual Bleeding
Heavy menstrual bleeding (HMB) may be the sentinel event for identifying a patient with a bleeding disorder (BD). The levonorgestrel intrauterine system (LNG IUS) has been proposed as a treatment for HMB in adolescents with and without BDs; however, no standard protocols for LNG IUS insertion in the...
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Veröffentlicht in: | Journal of pediatric & adolescent gynecology 2021-08, Vol.34 (4), p.514-521 |
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container_title | Journal of pediatric & adolescent gynecology |
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creator | O'Flynn O'Brien, Katherine L. Wheeler, Allison P. Borzutzky, Claudia Haley, Kristina M. Kouides, Peter Adeyemi-Fowode, Oluyemisi |
description | Heavy menstrual bleeding (HMB) may be the sentinel event for identifying a patient with a bleeding disorder (BD). The levonorgestrel intrauterine system (LNG IUS) has been proposed as a treatment for HMB in adolescents with and without BDs; however, no standard protocols for LNG IUS insertion in these populations exist. Providers were surveyed regarding the use of the LNG IUS in adolescents with HMB, with and without BD.
An institutional review board−approved survey assessing provider attitudes, LNG IUS insertion practices, and patient outcomes in adolescents with HMB, with and without BD, was electronically distributed to 3523 providers in the fields of hematology, adolescent medicine, and obstetrics and gynecology. Descriptive analysis was performed.
A total of 312 respondents across all 3 specialties completed the survey. Nearly 100% of respondents considered the LNG IUS safe and effective treatment for adolescents with HMB, both with and without BD. Additionally, 66% of providers chose LNG IUS as the ideal treatment for HMB in patients with BD. Differences were noted in clinical setting for LNG IUS insertion, peri-procedural medication use, and post-procedure follow-up among specialties. Providers across all specialties reported low complication rates related to IUS insertion and use in both patient groups.
Providers considered the LNG IUS safe and effective treatment for HMB in adolescents with and without a diagnosed BD. Practice patterns regarding LNG IUS insertion in this population vary. Further research is necessary to explore IUS outcomes in adolescent patients with HMB, with and without BD, and to inform evidence-based protocols for LNG IUS insertion. |
doi_str_mv | 10.1016/j.jpag.2021.01.014 |
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An institutional review board−approved survey assessing provider attitudes, LNG IUS insertion practices, and patient outcomes in adolescents with HMB, with and without BD, was electronically distributed to 3523 providers in the fields of hematology, adolescent medicine, and obstetrics and gynecology. Descriptive analysis was performed.
A total of 312 respondents across all 3 specialties completed the survey. Nearly 100% of respondents considered the LNG IUS safe and effective treatment for adolescents with HMB, both with and without BD. Additionally, 66% of providers chose LNG IUS as the ideal treatment for HMB in patients with BD. Differences were noted in clinical setting for LNG IUS insertion, peri-procedural medication use, and post-procedure follow-up among specialties. Providers across all specialties reported low complication rates related to IUS insertion and use in both patient groups.
Providers considered the LNG IUS safe and effective treatment for HMB in adolescents with and without a diagnosed BD. Practice patterns regarding LNG IUS insertion in this population vary. Further research is necessary to explore IUS outcomes in adolescent patients with HMB, with and without BD, and to inform evidence-based protocols for LNG IUS insertion.</description><identifier>ISSN: 1083-3188</identifier><identifier>EISSN: 1873-4332</identifier><identifier>DOI: 10.1016/j.jpag.2021.01.014</identifier><identifier>PMID: 33497749</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Female adolescents ; Heavy menstrual bleeding ; Hemostatic disorders ; Progesterone-releasing intrauterine devices</subject><ispartof>Journal of pediatric & adolescent gynecology, 2021-08, Vol.34 (4), p.514-521</ispartof><rights>2021 North American Society for Pediatric and Adolescent Gynecology</rights><rights>Copyright © 2021 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-c1268589d3017a148fd9c78d47585d1913acb516df8ac8ff2041fd52eba1f83f3</citedby><cites>FETCH-LOGICAL-c356t-c1268589d3017a148fd9c78d47585d1913acb516df8ac8ff2041fd52eba1f83f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpag.2021.01.014$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33497749$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O'Flynn O'Brien, Katherine L.</creatorcontrib><creatorcontrib>Wheeler, Allison P.</creatorcontrib><creatorcontrib>Borzutzky, Claudia</creatorcontrib><creatorcontrib>Haley, Kristina M.</creatorcontrib><creatorcontrib>Kouides, Peter</creatorcontrib><creatorcontrib>Adeyemi-Fowode, Oluyemisi</creatorcontrib><title>Provider Attitudes and Practices Regarding Intrauterine System (IUS) Insertion in Adolescents With and Without Bleeding Disorders for Management of Heavy Menstrual Bleeding</title><title>Journal of pediatric & adolescent gynecology</title><addtitle>J Pediatr Adolesc Gynecol</addtitle><description>Heavy menstrual bleeding (HMB) may be the sentinel event for identifying a patient with a bleeding disorder (BD). The levonorgestrel intrauterine system (LNG IUS) has been proposed as a treatment for HMB in adolescents with and without BDs; however, no standard protocols for LNG IUS insertion in these populations exist. Providers were surveyed regarding the use of the LNG IUS in adolescents with HMB, with and without BD.
An institutional review board−approved survey assessing provider attitudes, LNG IUS insertion practices, and patient outcomes in adolescents with HMB, with and without BD, was electronically distributed to 3523 providers in the fields of hematology, adolescent medicine, and obstetrics and gynecology. Descriptive analysis was performed.
A total of 312 respondents across all 3 specialties completed the survey. Nearly 100% of respondents considered the LNG IUS safe and effective treatment for adolescents with HMB, both with and without BD. Additionally, 66% of providers chose LNG IUS as the ideal treatment for HMB in patients with BD. Differences were noted in clinical setting for LNG IUS insertion, peri-procedural medication use, and post-procedure follow-up among specialties. Providers across all specialties reported low complication rates related to IUS insertion and use in both patient groups.
Providers considered the LNG IUS safe and effective treatment for HMB in adolescents with and without a diagnosed BD. Practice patterns regarding LNG IUS insertion in this population vary. Further research is necessary to explore IUS outcomes in adolescent patients with HMB, with and without BD, and to inform evidence-based protocols for LNG IUS insertion.</description><subject>Female adolescents</subject><subject>Heavy menstrual bleeding</subject><subject>Hemostatic disorders</subject><subject>Progesterone-releasing intrauterine devices</subject><issn>1083-3188</issn><issn>1873-4332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kd9uFCEUxonR2Fp9AS8Ml_ViVhiYGSbxZq1_ukkbG2vjJWHhsLKZgS0wm-w7-ZAy3dpLk5NwCN_3Ozl8CL2lZEEJbT9sF9ud2ixqUtMFmYs_Q6dUdKzijNXPS08EqxgV4gS9SmlLCOmaVrxEJ4zxvut4f4r-3MSwdwYiXubs8mQgYeUNvolKZ6fL7QdsVDTOb_DK56imDNF5wLeHlGHE56u72_flJUHMLnjsPF6aMEDS4HPCv1z-_cCbmzBl_GkAeIB9dinEMjdhGyK-Vl5tYCweHCy-BLU_4GvwKcdJDU-m1-iFVUOCN4_nGbr7-uXnxWV19f3b6mJ5VWnWtLnStG5FI3rDCO0U5cKaXnfC8K4RjaE9ZUqvG9oaK5QW1taEU2uaGtaKWsEsO0PnR-4uhvsJUpajKwsNg_IQpiRrLmjLOaVtkdZHqY4hpQhW7qIbVTxISuScktzKOSU5pyTJXLyY3j3yp_UI5snyL5Yi-HgUQNly7yDKpB14XX4hgs7SBPc__l-Y3aZN</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>O'Flynn O'Brien, Katherine L.</creator><creator>Wheeler, Allison P.</creator><creator>Borzutzky, Claudia</creator><creator>Haley, Kristina M.</creator><creator>Kouides, Peter</creator><creator>Adeyemi-Fowode, Oluyemisi</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20210801</creationdate><title>Provider Attitudes and Practices Regarding Intrauterine System (IUS) Insertion in Adolescents With and Without Bleeding Disorders for Management of Heavy Menstrual Bleeding</title><author>O'Flynn O'Brien, Katherine L. ; Wheeler, Allison P. ; Borzutzky, Claudia ; Haley, Kristina M. ; Kouides, Peter ; Adeyemi-Fowode, Oluyemisi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-c1268589d3017a148fd9c78d47585d1913acb516df8ac8ff2041fd52eba1f83f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Female adolescents</topic><topic>Heavy menstrual bleeding</topic><topic>Hemostatic disorders</topic><topic>Progesterone-releasing intrauterine devices</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O'Flynn O'Brien, Katherine L.</creatorcontrib><creatorcontrib>Wheeler, Allison P.</creatorcontrib><creatorcontrib>Borzutzky, Claudia</creatorcontrib><creatorcontrib>Haley, Kristina M.</creatorcontrib><creatorcontrib>Kouides, Peter</creatorcontrib><creatorcontrib>Adeyemi-Fowode, Oluyemisi</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric & adolescent gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O'Flynn O'Brien, Katherine L.</au><au>Wheeler, Allison P.</au><au>Borzutzky, Claudia</au><au>Haley, Kristina M.</au><au>Kouides, Peter</au><au>Adeyemi-Fowode, Oluyemisi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Provider Attitudes and Practices Regarding Intrauterine System (IUS) Insertion in Adolescents With and Without Bleeding Disorders for Management of Heavy Menstrual Bleeding</atitle><jtitle>Journal of pediatric & adolescent gynecology</jtitle><addtitle>J Pediatr Adolesc Gynecol</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>34</volume><issue>4</issue><spage>514</spage><epage>521</epage><pages>514-521</pages><issn>1083-3188</issn><eissn>1873-4332</eissn><abstract>Heavy menstrual bleeding (HMB) may be the sentinel event for identifying a patient with a bleeding disorder (BD). The levonorgestrel intrauterine system (LNG IUS) has been proposed as a treatment for HMB in adolescents with and without BDs; however, no standard protocols for LNG IUS insertion in these populations exist. Providers were surveyed regarding the use of the LNG IUS in adolescents with HMB, with and without BD.
An institutional review board−approved survey assessing provider attitudes, LNG IUS insertion practices, and patient outcomes in adolescents with HMB, with and without BD, was electronically distributed to 3523 providers in the fields of hematology, adolescent medicine, and obstetrics and gynecology. Descriptive analysis was performed.
A total of 312 respondents across all 3 specialties completed the survey. Nearly 100% of respondents considered the LNG IUS safe and effective treatment for adolescents with HMB, both with and without BD. Additionally, 66% of providers chose LNG IUS as the ideal treatment for HMB in patients with BD. Differences were noted in clinical setting for LNG IUS insertion, peri-procedural medication use, and post-procedure follow-up among specialties. Providers across all specialties reported low complication rates related to IUS insertion and use in both patient groups.
Providers considered the LNG IUS safe and effective treatment for HMB in adolescents with and without a diagnosed BD. Practice patterns regarding LNG IUS insertion in this population vary. Further research is necessary to explore IUS outcomes in adolescent patients with HMB, with and without BD, and to inform evidence-based protocols for LNG IUS insertion.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33497749</pmid><doi>10.1016/j.jpag.2021.01.014</doi><tpages>8</tpages></addata></record> |
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subjects | Female adolescents Heavy menstrual bleeding Hemostatic disorders Progesterone-releasing intrauterine devices |
title | Provider Attitudes and Practices Regarding Intrauterine System (IUS) Insertion in Adolescents With and Without Bleeding Disorders for Management of Heavy Menstrual Bleeding |
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