Teen pregnancy prevention on a LARC:  an update on long-acting reversible contraception for the primary care provider.
OBJECTIVE
This update will highlight recent research and recommendations on long-acting reversible contraception (LARC) in the teen population, in order to make primary care providers more comfortable counseling on these methods in the medical home. LARC methods, which include intrauterine devices (IUDs) and subdermal hormonal implants, are used by only a small minority of sexually active teens, despite their endorsement by professional organizations as effective and well tolerated birth control options in this population.


RESULTS
Recent studies show a lack of knowledge about LARC methods among young women, as well as persistent misconceptions among providers regarding who is eligible for LARC use. Existing trials of small numbers of adolescents generally show enthusiasm for its use among teens who are educated about LARC, high satisfaction rates among users of subdermal implants and IUDs, as well as varying pregnancy and continuation rates.


CONCLUSIONS
The existing research on LARC shows promise for these methods in the teen population. However, larger trials are needed to establish accurate data on satisfaction, continuation, and failure rates, as well as to explore other barriers to use. Medical home providers should stay informed of research on LARC in order to improve contraceptive counseling to young women.
Division of Adolescent/Young Adult Medicine, Children's Hospital Boston, Harvard Medical School, USA. nancy.dodson@childrens.harvard.edu
Nancy A
NA
Dodson
Susan H
SH
Gray
Pamela J
PJ
Burke
D000293:Adolescent; D003267:Contraception / Q000379:methods*; D003376:Counseling / Q000458:organization & administration*; D005193:Family Planning Services / Q000458:organization & administration*; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D007434:Intrauterine Devices; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000592:standards*; D012736:Sex Education; D014481:United States; D055815:Young Adult