Effectiveness and Acceptability of Medical Abortion Provided Through Telemedicine
Authors:
- Daniel GrossmanDGDaniel Grossman
- Kate GrindlayKGKate Grindlay
- Todd BuchackerTBTodd Buchacker
- Kathleen LaneKLKathleen Lane
- Kelly BlanchardKBKelly Blanchard
- 1 August 2011
- journal article
- research article
- Published by Wolters Kluwer Health in Obstetrics & Gynecology
- Vol. 118 (2) , 296-303
Abstract
To estimate the effectiveness and acceptability of telemedicine provision of early medical abortion compared with provision with a face-to-face physician visit at a Planned Parenthood affiliate in Iowa. Between November 2008 and October 2009, we conducted a prospective cohort study of women obtaining medical abortion by telemedicine or face-to-face physician visits. We collected clinical data, and women completed a self-administered questionnaire at follow-up. We also compared the prevalence of reportable adverse events between the two service delivery models among all patients seen between July 2008 and October 2009. Of 578 enrolled participants, follow-up data were obtained for 223 telemedicine patients and 226 face-to-face patients. The proportion with a successful abortion was 99% for telemedicine patients (95% confidence interval [CI] 96–100%) and 97% for face-to-face patients (95% CI 94–99%). Ninety-one percent of all participants were very satisfied with their abortion, although in multivariable analysis, telemedicine patients had a higher odds of saying they would recommend the service to a friend compared with face-to-face patients (odds ratio, 1.72; 95% CI 1.26–2.34). Twenty-five percent of telemedicine patients said they would have preferred being in the same room with the doctor. Younger age, less education, and nulliparity were significantly associated with preferring face-to-face communication. There was no significant difference in the prevalence of adverse events reported during the study period among telemedicine patients (n=1,172) (1.3%; 95% CI 0.8–2.1%) compared with face-to-face patients (n=2,384) (1.3%; 95% CI 0.9–1.8%) (82% power to detect difference of 1.3%). Provision of medical abortion through telemedicine is effective and acceptability is high among women who choose this model. IIKeywords
This publication has 18 references indexed in Scilit:
- A systematic review of economic analyses of telehealth services using real time video communicationBMC Health Services Research, 2010
- Effect of Mifepristone on Abortion Access in the United StatesObstetrics & Gynecology, 2009
- Rates of Serious Infection after Changes in Regimens for Medical AbortionNew England Journal of Medicine, 2009
- Non-physician clinicians can safely provide first trimester medical abortionReproductive Health Matters, 2009
- Provision of abortion by mid-level providers: international policy, practice and perspectivesBulletin of the World Health Organization, 2009
- Two Distinct Oral Routes of Misoprostol in Mifepristone Medical AbortionObstetrics & Gynecology, 2008
- A Note on Robust Variance Estimation for Cluster‐Correlated DataBiometrics, 2000
- Acceptability and Feasibility of Early Pregnancy Termination by Mifepristone-Misoprostol: Results of a Large Multicenter Trial in the United StatesArchives of Family Medicine, 1998
- Early Pregnancy Termination with Mifepristone and Misoprostol in the United StatesNew England Journal of Medicine, 1998
- Consistent Covariance Matrix Estimation with Cross-Sectional Dependence and Heteroskedasticity in Financial DataJournal of Financial and Quantitative Analysis, 1989