{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:53:12Z","timestamp":1777953192667,"version":"3.51.4"},"reference-count":22,"publisher":"BMJ","issue":"2","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":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2018,2,14]]},"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Intrauterine contraception (IUC) is highly effective, safe and long-lasting, but is not a popular method of contraception among British women. This study examined barriers to the uptake of IUC in general practice in England.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>A sequential mixed-method approach to explore the views of practitioners regarding the provision of IUC. We e-surveyed 208 practitioners from 69 practices in a region of England and subsequently interviewed 14 practitioners from eight practices.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Just under half of general practitioners (GPs) (46.8%; 58\/124), and only 8.2% (4\/49) of nurses reported being trained to fit IUC. Lack of knowledge of IUC was a barrier to fitting, and also to recommending IUC, especially by practitioners who were not trained to fit. There was discordance between reported knowledge of eligibility for IUC and the likelihood of recommending IUC. Respondents were less likely to recommend IUC to young, nulliparous women, women who had experienced a previous ectopic pregnancy, a recent sexually transmitted infection (STI), or an abnormal cervical smear. The qualitative data indicate that risk aversion and limited training, together with practitioners\u2019 assessments that women are uninterested, may lead to IUC being precluded as a suitable method.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Increased practitioner education, for those not trained to fit IUC, may remove a barrier to the uptake of IUC in general practice. More research is required on the discordance between the practitioners\u2019 views on the characteristics of women considered suitable for IUC, and the criteria set out in the UK Medical Eligibility Criteria (UKMEC) guidelines.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2017-101805","type":"journal-article","created":{"date-parts":[[2018,3,6]],"date-time":"2018-03-06T20:40:31Z","timestamp":1520368831000},"page":"82-89","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Provider-based barriers to provision of intrauterine contraception in general practice"],"prefix":"10.1136","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4786-7950","authenticated-orcid":false,"given":"Lesley","family":"Hoggart","sequence":"first","affiliation":[{"name":"Faculty of Health and Social Care, The Open University, Milton Keynes, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2426-1470","authenticated-orcid":false,"given":"Susan","family":"Walker","sequence":"additional","affiliation":[{"name":"Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria Louise","family":"Newton","sequence":"additional","affiliation":[{"name":"Faculty of Health and Social Care, The Open University, Milton Keynes, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike","family":"Parker","sequence":"additional","affiliation":[{"name":"Faculty of Health, Social Care and Education, Post Graduate Medical Institute, Anglia Ruskin University, Chelmsford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,3,6]]},"reference":[{"key":"2025090511515166000_44.2.82.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2010.02.020"},{"key":"2025090511515166000_44.2.82.2","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2010.2658"},{"key":"2025090511515166000_44.2.82.3","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.contraception.2013.02.004","article-title":"Perceptions of intrauterine contraception among women seeking primary care","volume":"88","author":"Callegari","year":"2013","journal-title":"Contraception"},{"key":"2025090511515166000_44.2.82.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2012.02.017"},{"key":"2025090511515166000_44.2.82.5","unstructured":"National Institute for Health and Care Excellence (NICE). Long-acting reversible contraception. NICE Guideline No. 30 [CG30]. 2005. https:\/\/www.nice.org.uk\/guidance\/cg30 (accessed 10 Feb 2018)"},{"key":"2025090511515166000_44.2.82.6","unstructured":"National Health Service (NHS) Digital 2016. Sexual and Reproductive Health Services \u2013 England. Data Tables 2015-16.http:\/\/digital.nhs.uk\/pubs\/sexrepseroct16 (accessed 10 Feb 2018)"},{"key":"2025090511515166000_44.2.82.7","doi-asserted-by":"crossref","first-page":"155","DOI":"10.2147\/OAJC.S116994","article-title":"Predictors of non-use of intrauterine contraception among women aged 18-49 years in a general practice setting in the UK","volume":"7","author":"Walker","year":"2016","journal-title":"Open Access J Contracept"},{"key":"2025090511515166000_44.2.82.8","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.contraception.2009.11.006","article-title":"Health care providers' knowledge about contraceptive evidence: a barrier to quality family planning care?","volume":"81","author":"Dehlendorf","year":"2010","journal-title":"Contraception"},{"key":"2025090511515166000_44.2.82.9","first-page":"637","article-title":"Evidence-based IUD practice: family physicians and obstetrician-gynecologists","volume":"44","author":"Harper","year":"2012","journal-title":"Fam Med"},{"key":"2025090511515166000_44.2.82.10","doi-asserted-by":"crossref","first-page":"e169","DOI":"10.1016\/j.midw.2014.02.002","article-title":"Knowledge and reported confidence of final year midwifery students regarding giving advice on contraception and sexual health","volume":"30","author":"Walker","year":"2014","journal-title":"Midwifery"},{"key":"2025090511515166000_44.2.82.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2010.10.003"},{"key":"2025090511515166000_44.2.82.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2010.07.009"},{"key":"2025090511515166000_44.2.82.13","doi-asserted-by":"publisher","DOI":"10.1136\/jfprhc-2012-100477"},{"key":"2025090511515166000_44.2.82.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2007.05.085"},{"key":"2025090511515166000_44.2.82.15","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.ejogrb.2014.10.020","article-title":"Understanding the barriers and myths limiting the use of intrauterine contraception in nulliparous women: results of a survey of European\/Canadian healthcare providers","volume":"183","author":"Buhling","year":"2014","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2025090511515166000_44.2.82.16","unstructured":"Faculty of Sexual & Reproductive Healthcare (FSRH). UK Medical Eligibility Criteria for Contraceptive Use (UKMEC) Summary Sheets. 2010."},{"key":"2025090511515166000_44.2.82.17","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1136\/bmjsrh-2017-101798","article-title":"\u201cI think maybe 10 years seems a bit long\u201d: beliefs and attitudes of women who had never used IUC","volume":"44","author":"Walker","year":"2018","journal-title":"BMJ Sex Reprod Health"},{"key":"2025090511515166000_44.2.82.18","unstructured":"Braun V , Clarke V . Successful qualitative research. London, UK: Sage Publications, 2013."},{"key":"2025090511515166000_44.2.82.19","unstructured":"Royal College of General Practitioners (RCGP). Position statement. 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