Changing Times, Changing Minds: A QI Project to Increase Family Medicine Physician Knowledge and Comfort Levels with Prescribing Analgesia and Anxiolytics for IUD Insertions

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-8-2026

Abstract

Intrauterine devices (IUDs) are a highly effective form of long-acting reversible contraception. However, patient pain and anxiety during insertion remain significant barriers for effective implementation and use. Current best practice advisories from groups including but not limited to the AAFP and ACOG recommend offering adequate pain and anxiety control to patients undergoing IUD insertion. However, current practice within the Corewell Health West Family Medicine residency clinics lack a standardized approach to address pain and anxiety before, during, and after IUD insertions. It is unclear if this is due to lack of family medicine physicians' knowledge and/or comfort levels surrounding options for pain and anxiety management for IUD insertions.

To assess if family medicine physician knowledge and/or comfort levels with recommending options for pain and anxiety management for IUD insertions is a barrier to offering these interventions, we conducted a quality improvement project using the Corewell Health West Family Medicine residents and attendings as our focus population. A pre-survey was developed to assess baseline knowledge and comfort levels with pain and anxiety management options for IUD insertions. After completion of the pre-survey, a didactics lecture reviewing evidenced-based options and guidelines for pain and anxiety control before, during, and after IUD insertions was presented. Two months after the lecture, a post-survey was provided to assess if physician knowledge, comfort levels, and practice changed following the lecture. The primary endpoint was the change in the pre-lecture and post-lecture scores, with a 10% increase in positive responses between pre- and post-surveys defined as improvement from baseline.

At the time of abstract submission, post-survey responses were still being collected. If there is a 10% increase in positive responses between pre- and post-survey answers, this may suggest lack of training on the evidenced-based options for pain and anxiety management during outpatient IUD insertions is a potential barrier to offering patients the standard of care.

IUD's are a highly effective and reliable form of contraception. However, many patients experience significant anxiety about the insertion procedure itself, which is largely due to concerns about pain. By assessing if physician lack of knowledge and/or comfort levels are barriers to offering options for pain and anxiety management, this study has the potential to improve patient experiences and increase the number of patients who would pursue IUDs as a form of contraception.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 1913

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