Telemedicine medical abortion service in Georgia: an evaluation of a strategy with reduced number of in-Clinic visits

Abstract

Purpose

To evaluate feasibility and acceptability of a medical abortion service that offers: a telemedicine visit (in place of an in-person visit) during a mandatory waiting period, and at-home follow-up with the use of multi-level pregnancy tests (MLPT).

Methods

Participants were screened for eligibility in clinic, and during the waiting period, received a telephone call to confirm desire to proceed with the service. Participants were mailed a study package containing mifepristone, misoprostol, two multi-level pregnancy tests, and instructions for their use. Follow-up consultation took place by phone to evaluate abortion completeness. The analysis was descriptive.

Results

One-hundred twenty-two participants were enrolled in the study, and 120 chose to proceed with the abortion after the waiting period and were sent a study package. One participant was lost to follow up. The majority of participants did not experience problems receiving the study package (94.1%, n = 112), took mifepristone (100%, n = 119), misoprostol (99.2%, n = 118), and MLPTs (99.1%, n = 116) as instructed, and forwent additional clinic visits (91.6%, n = 109). All participants were satisfied with the service. Most participants had a complete abortion without a procedure (95.8%, n = 114).

Conclusions

The adapted telemedicine medical abortion service was feasible and satisfactory to participants and has the potential to make medical abortion more patient-centered where waiting periods are mandated.

摘要

目的：评估医疗堕胎服务的可行性和可接受性, 该服务:在等待期提供远程医疗访问(取代亲自访问), 并使用多级妊娠测试(MLPT)在家随访。

方法：参与者在诊所接受资格筛选, 在等待期, 她们会接到一个电话, 确认是否愿意继续接受服务。邮寄给参与者一个含有米非司酮、米索前列醇、两种多级妊娠测试以及使用说明的研究包裹。通过电话随访评估流产完全性。进行描述性分析。

结果：122名参与者参与了这项研究, 其中120人在等待期后选择继续堕胎, 并收到了研究包裹。一名参与者失访。大多数参与者在接受研究包裹时没有遇到问题(94.1%, n=112), 按照指导服用米非司酮(100%, n=119)、米索前列醇(99.2%, n=118)和填写多级妊娠测试(99.1%, n=116), 并放弃额外的临床就诊(91.6%, n=109)。所有参加者都对服务表示满意。大多数参与者在没有手术的情况下完全流产(95.8%, n=114)。

结论：经过调整的远程医疗堕胎服务是可行的, 参与者感到满意, 并有可能在等待期内使医疗堕胎更加以病人为中心。

Keywords:

• Mifepristone
• medical abortion
• telemedicine
• multi-level pregnancy test

Disclosure statement

No potential competing interest was reported by the authors.

Additional information

Funding

This work was supported by Grand Challenges Canada.