Primary Care Training Drives Higher Adoption and Continued Use of LARC Methods: 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 examined whether increased use of long-acting reversible contraception (LARC) can reduce the rate of unintended pregnancies and abortions.

The study

Researchers conducted a follow-up study of the highly successful ACCORd (Australian Contraceptive ChOice pRoject) trial, which provided training for general practitioners (GPs) in structured, nonbiased contraceptive counseling and access to rapid referral for LARC insertion while control physicians provided usual care. Results were published in 2020 and demonstrated much higher rates of LARC uptake among women who were treated by the trained GPs.

This 3-year longitudinal follow-up of ACCORd included 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. Among those initiating LARC within 6 months, 66% sustained use at 3 years, above the 55% continuation rate for oral contraceptives.

• IUD continuation. Continuation rates for hormonal IUDs were highest at 80%, with copper IUDs at 69% and implants at 46%. These results, consistent with international trends, validate the provider-centered approach.

• Unintended pregnancy and procedure rates. The 3-year incidence of unintended pregnancy was reduced by half in the intervention group compared to the standard care group (3.1% vs 6.3%), and abortion rates dropped (0.9% vs 3.6%).

• User satisfaction and method preferences. Eighty-two percent of LARC users were “very satisfied,” compared to 63% for oral contraceptive users. Hormonal IUDs led satisfaction ratings (86%), followed by copper IUDs (78%) and implants (72%).

Authors' comments

"Our findings of high uptake and rates of continuation of LARC methods over time are similar to those of the US Contraceptive CHOICE Project study. 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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