title: Factors associated with elective Norplant removal in black and white women.
abstract: Premature removal of contraceptive implants (Norplant [levonorgestrel implants], Wyeth-Ayerst Laboratories, Philadelphia, Pennsylvania) is a cause of a sizable national medical expenditure in the United States. Understanding the factors that influence the decision to remove the implants and being able to predict which users are likely to elect discontinuation prematurely could provide useful information for counseling patients as they are considering contraceptive implants so that potentially enormous long-term savings could be achieved. This study surveyed 98 women who had Norplant inserted and removed between January 1991 and December 1994. Data were collected from chart review, and when necessary, a questionnaire was used to extract information not found in the chart. The chi-squared statistic and t-test were used to compare demographic variables. All but one subject received comprehensive pre-implant counseling. The main reason given for electively removing the Norplant prematurely was irregular menstrual bleeding (60%). Pre-implant counseling did not influence the decision for removal. These results indicate the importance of clarifying patients' doubts regarding menstrual bleeding irregularities during follow-up visits rather than relying on the information patients received during preimplant counseling.
authors.affiliation: Department of Family and Preventive Medicine, Meharry Medical College, Nashville, Tennessee, USA.
authors.forename: J U
authors.initials: JU
authors.lastname: Opara
authors.forename: F A
authors.initials: FA
authors.lastname: Ernst
authors.forename: H
authors.initials: H
authors.lastname: Gaskin
authors.forename: L
authors.initials: L
authors.lastname: Smith
authors.forename: H V
authors.initials: HV
authors.lastname: Nevels
mesh_terms: D000328:Adult; D001741:Black or African American; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D003376:Counseling; D004343:Drug Implants; D005260:Female; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000009:adverse effects; D010349:Patient Compliance; D011795:Surveys and Questionnaires; D044465:White People
chemical_list: D003271:Contraceptive Agents, Female; D004343:Drug Implants; D016912:Levonorgestrel