Primary Care Training Boosts LARC Uptake and Long-Term Retention: Daily Dose

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On October 14, 2025, we reported on findings from a study published in the American Journal of Obstetrics and Gynecology that was designed to assess whether the ACCORd (Australian Contraceptive ChOice pRoject) trial intervention resulted in sustained long-acting reversible contraception (LARC) use and decreased unplanned pregnancies.

The study

Researchers conducted a longitudinal 3-year follow-up study of the original ACCORd cluster randomized controlled trial. Included in the follow-up study were women seen by the intervention group of clinicians ACCORd family physicians who had completed a survey 12 months after LARC insertion. The primary outcome was continuation of LARC versus non-LARC methods; secondary outcomes included contraceptive method choice, satisfaction with the choice, and rates of unintended pregnancy and abortion.

The findings

• LARC uptake and continuation. At 3 years after intervention, 41% of women in the intervention group continued using LARC, compared to 28% in usual care.

• OC continuation. The overall rate of continuation for LARC methods (66%) was significantly higher than for non-LARC methods (55%; P =.027).

• Unintended Pregnancy. Women in the intervention group experienced significantly fewer unintended pregnancies (3.1%) compared to the control group (6.3%; Odds Ratio 0.38).

• Abortion Rate. Women in the intervention group also experienced significantly fewer abortions (0.9%) compared to the control group (3.6%; Odds Ratio 0.10).

• Satisfaction. Satisfaction with the contraceptive method was reported as higher among LARC users compared to oral contraceptive pill users.

Authors' comments

"Implementation of the ACCORd intervention should be considered in primary care contexts where LARC uptake is low, free contraception is not feasible, and specific sexual and reproductive health services are not available or accessible."

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