Barriers to implementation of long-acting reversible contraception: A systematic review

Background and purpose:Long-acting reversible contraception (LARC) is one of the most effective forms of contraception available. The utilization of LARC remains low despite being recommended by major health organizations such as Centers for Disease Control and Prevention, American Congress of Obstetricians and Gynecologists, American Academy of Pediatrics, American Academy of Family Physicians, and the National Committee for Quality Assurance. Health care professionals play an essential role in the potential increased use of LARC. This review aims to highlight key barriers to the utilization of LARC and discuss interventions to address this issue.Methods:A systematic review of 14 peer-reviewed articles focused on LARC utilization rates that help identify barriers to the utilization of LARC in current education and practice. Articles were evaluated for strength of research design using the Johns Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal tool.Conclusions:Three categories affecting LARC utilization emerged: deficits in provider education/competency, lack of hands-on training, and barriers to practice.Implications for practice:The importance of including LARC training and education in the advanced practice nursing curriculum and providing opportunities for continuing education with LARC is demonstrated.