Study Objective

To describe adolescent and young adult (AYA) long-acting reversible contraception (LARC) follow-up care via telemedicine in the year following the COVID-19 pandemic onset

Design

Longitudinal cohort study

Setting

Three academic adolescent medicine clinics in the United States

Participants

AYAs using LARC

Interventions

None

Main Outcome Measures

The main outcome measures were patient characteristics, visit information (frequency, timing, and modality), patient-reported symptoms, and outcomes for those presenting for LARC follow-up care between April 1, 2020, and March 31, 2021. Descriptive statistics were used to describe the sample. χ² tests and t tests were used to compare groups. Adjusted logistic regression models using general estimating equations were applied to assess factors associated with telemedicine visits and to examine visit outcomes.

Results

Of the 319 AYAs (ages 13.6-25.7 years), 40.1% attended at least one LARC telemedicine visit. Patients attending any telemedicine encounter vs only in-person visits had similar demographic and clinical characteristics. Of the 426 follow-up visits, 270 (63.4%) were conducted in person and 156 (36.6%) were performed via telemedicine. Most visits (62.7%) occurred within 12 months of device insertion. Reports of bothersome uterine bleeding beyond patient expectations (OR = 1.26; 95% CI, 0.80-1.96), any symptom (OR = 1.40; 95% CI, 0.94-2.10), or 2 or more symptoms (OR = 1.22; 95% CI, 0.67-2.22) at follow-up was not associated, positively or negatively, with mode of follow-up. Management of bleeding (OR = 1.27; 95% CI, 0.56-2.89), management of acne (P = .46), and need for rapid follow-up (P = .33) were similar between follow-up modalities.

Conclusions

Patient demographic/clinical characteristics and visit outcomes were similar between telemedicine and in-person LARC follow-up. Telemedicine could play an important role in AYA LARC care.

中文翻译：

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全球大流行中青少年和青年长效可逆避孕后续护理的远程医疗

学习目标

描述 COVID-19 大流行爆发后一年内通过远程医疗对青少年和年轻成人 (AYA) 长效可逆避孕 (LARC) 进行的后续护理

设计

纵向队列研究

环境

美国三个学术青少年医学诊所

参加者

使用 LARC 的 AYA

干预措施

没有任何

主要观察指标

主要结果指标是患者特征、就诊信息（频率、时间和方式）、患者报告的症状以及 2020 年 4 月 1 日至 2021 年 3 月 31 日期间接受 LARC 随访护理的患者的结果。描述性统计数据为用于描述样本。χ ²检验和t检验用于组间比较。使用一般估计方程调整后的逻辑回归模型被应用于评估与远程医疗就诊相关的因素并检查就诊结果。

结果

在 319 名 AYA（年龄 13.6-25.7 岁）中，40.1% 的人至少参加了一次 LARC 远程医疗就诊。参加任何远程医疗会诊与仅亲自就诊的患者具有相似的人口统计学和临床​​特征。在 426 次随访中，270 次 (63.4%) 是亲自进行的，156 次 (36.6%) 通过远程医疗进行的。大多数访问 (62.7%) 发生在设备插入后 12 个月内。超出患者预期的令人烦恼的子宫出血报告（OR = 1.26；95% CI，0.80-1.96）、任何症状（OR = 1.40；95% CI，0.94-2.10）或 2 种或更多症状（OR = 1.22；95% CI, 0.67-2.22) 在随访时与随访模式没有正相关或负相关。出血管理（OR = 1.27；95% CI，0.56-2.89）、痤疮管理（P  = .46）和快速随访需求（P = .33) 在随访方式之间相似。

结论

远程医疗和面对面 LARC 随访的患者人口统计学/临床特征和就诊结果相似。远程医疗可以在 AYA LARC 护理中发挥重要作用。