{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:20:12Z","timestamp":1791382812001,"version":"4.3.3"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,3,10]],"date-time":"2017-03-10T00:00:00Z","timestamp":1489104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000801","name":"Bayer HealthCare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000801","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Australia's abortion rates are among the highest in the developed world. Efficacy of the most commonly used form of contraception (oral contraceptives and condoms) relies on regular user compliance. Long\u2010acting reversible contraception (LARC) virtually eradicates contraceptive failure as it is not user\u2010dependent; however, its uptake has been low.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To provide an overview of barriers to LARC use in Australia and potential strategies to overcome these barriers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A roundtable of Australian experts was convened to share clinical perspectives and to explore the barriers and potential strategies to increase LARC\u00a0use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three broad barriers to LARC uptake were identified. (i) A paucity of Australian research exists that impedes closure of evidence gaps regarding contraceptive prescription and use. Systematic data collection is required. (ii) Within primary care, lack of familiarity with LARC and misperceptions about its use, lack of access to general practitioners (GPs) trained in LARC insertion\/removal and affordability impede LARC uptake. Potential strategies to encourage LARC use include, GP education to promote informed choice by women, training in LARC insertions\/removals, effective funding models for nurses to perform LARC insertions\/removals, and rapid referral pathways. (iii) At the health system level, primary care incentives to provide LARC to women and health economic analyses to inform government policy changes are required.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although LARC decreases unintended pregnancies by eliminating user compliance issues, its uptake is low in Australia. Strategies that promote LARC uptake by targeting specific barriers may effectively reduce Australia's high unintended pregnancy rate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12587","type":"journal-article","created":{"date-parts":[[2017,3,10]],"date-time":"2017-03-10T15:36:10Z","timestamp":1489160170000},"page":"206-212","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":78,"title":["Current barriers and potential strategies to increase the use of long\u2010acting reversible contraception (LARC) to reduce the rate of unintended pregnancies in Australia: An expert roundtable discussion"],"prefix":"10.1111","volume":"57","author":[{"given":"Danielle","family":"Mazza","sequence":"first","affiliation":[{"name":"Department of General Practice, Monash University  Notting Hill Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Bateson","sequence":"additional","affiliation":[{"name":"Family Planning NSW  Ashfield New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Frearson","sequence":"additional","affiliation":[{"name":"Australasian Menopause Society  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Goldstone","sequence":"additional","affiliation":[{"name":"Marie Stopes International Australia  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gab","family":"Kovacs","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash Medical Centre  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rod","family":"Baber","sequence":"additional","affiliation":[{"name":"Sydney Medical School University of Sydney  New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,3,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1753-6405.12098"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728-4465.2010.00250.x"},{"key":"e_1_2_6_4_1","unstructured":"Family Planning NSW.Reproductive and sexual health in Australia.Ashfield Sydney:Family Planning NSW 2013."},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1400506"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1110855"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2016.06.016"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/jfprhc\u20102015\u2010101356"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2011.tb02988.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2013.06.005"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2010.01136.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jfprhc\u20102014\u2010101132"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/13625187.2013.777830"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/den091"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2008.08.003"},{"key":"e_1_2_6_16_1","unstructured":"PrattA BiggsA BuckmasterL.How many abortions are there in Australia? A discussion of abortion statistics their limitations and options for improved statistical collection.Canberra:Parliament of Australia Department of Parliamentary Services 2005."},{"key":"e_1_2_6_17_1","first-page":"367","article-title":"Current contraceptive management in Australia general practice: an analysis of BEACH data","volume":"6","author":"Mazza D","year":"2012","journal-title":"Med J Aust"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.3109\/13625187.2011.580864"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.3109\/13625187.2014.919380"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja14.00011"},{"issue":"115","key":"e_1_2_6_21_1","first-page":"e1","article-title":"The Contraceptive CHOICE Project: reducing barriers to long\u2010acting reversible contraception","volume":"203","author":"Secura G","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_6_22_1","unstructured":"Australian Government Department of Health. Pharmaceutical Benefits Scheme 2014. [cited 9 September 2014.] Available from URL:www.pbs.gov.au\/pbs\/home."},{"key":"e_1_2_6_23_1","unstructured":"Family Planning Alliance Australia. Efficacy of contraception methods 2014. [cited 17 October 2016.] Available from URL:http:\/\/familyplanningallianceaustralia.org.au\/wp-content\/uploads\/2014\/11\/FPAA_Efficacy_SCREEN.pdf."},{"key":"e_1_2_6_24_1","unstructured":"World Health Organization Department of Reproductive Health and Research (WHO\/RHR) Johns Hopkins Bloomberg School of Public Health\/Center for Communication Programs (CCP) Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2011 update).Baltimore and Geneva:CCP and WHO 2011. [Accessed October 17 2016.] Available from URL:http:\/\/www.who.int\/reproductivehealth\/publications\/family_planning\/9780978856304\/en\/"},{"key":"e_1_2_6_25_1","volume-title":"Medical Eligibility Criteria for Contraceptive use","author":"World Health Organization","year":"2015"},{"key":"e_1_2_6_26_1","unstructured":"Bayer Healthcare Pharmaceuticals.Mirena Product Information 2014."},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01256.x"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0092205"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fajo.12587","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.12587","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T07:38:32Z","timestamp":1695541112000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.12587"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,10]]},"references-count":27,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,4]]}},"alternative-id":["10.1111\/ajo.12587"],"URL":"https:\/\/doi.org\/10.1111\/ajo.12587","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,10]]},"assertion":[{"value":"2016-03-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-11-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-03-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}