Surveillance decision

Surveillance decision

We will not update the guideline on long-acting reversible contraception (LARC) at this time.

We will amend the guideline to:

  • Add a cross referral to the NICE guideline on contraceptive services for under 25s (published March 2014) in sections 1.1.1 to 1.1.6.

  • Add a cross referral to the NICE local government briefing on contraceptive services (published March 2014) in sections 1.1.1 to 1.1.6.

  • Update appendix A and appendix B based on new product availability.

  • Include a medicines prescribing briefing, prepared by the NICE medicines and prescribing team to provide evidence-based information for the different types of LARCs. The outdated recommendations in the guideline will be stood down and replaced with a cross referral to this medicines prescribing briefing as well as a link to the British national formulary (BNF).

Reason for the decision

Assessing the evidence

We found 120 additional studies through surveillance of this guideline.

This included evidence on contraception and principles of care, copper intrauterine devices and progestogen-only subdermal implants, which support current recommendations. We also identified evidence that was not consistent with current recommendations on intrauterine system and progestogen-only injectable contraceptives.

We asked topic experts whether this evidence would affect current recommendations. The topic experts indicated that the service delivery and provision of care have considerably changed and new intrauterine systems are available since the guideline was developed and the recommendations no longer fit with current practice.

We also found evidence on self-administration of subcutaneous depo-medroxyprogesterone acetate (sc‑DMPA) and immediate intrauterine contraceptive device insertion following caesarean section, which was not covered in the guideline.


No equalities issues were identified during the surveillance process.

Overall decision

After considering all the evidence and views of topic experts and stakeholders, we decided that no update is necessary for this guideline.

See how we made the decision for further information.

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