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At-home telemedicine for medical abortion in Australia: a qualitative study of patient experiences and recommendations
  1. Laura Fix1,
  2. Jane W Seymour1,
  3. Monisha Vaid Sandhu2,
  4. Catriona Melville2,
  5. Danielle Mazza3,
  6. Terri-Ann Thompson1
  1. 1 Ibis Reproductive Health, Cambridge, Massachusetts, United States
  2. 2 Marie Stopes Australia, Melbourne, Victoria, Australia
  3. 3 Department of General Practice, Monash University, Notting Hill, Victoria, Australia
  1. Correspondence to Laura Fix, Ibis Reproductive Health, Cambridge, MA 02140, USA; lfix{at}ibisreproductivehealth.org

Abstract

Introduction This study aimed to explore patient experiences obtaining a medical abortion using an at-home telemedicine service operated by Marie Stopes Australia.

Methods From July to October 2017, we conducted semistructured in-depth telephone interviews with a convenience sample of medical abortion patients from Marie Stopes Australia. We analysed interview data for themes relating to patient experiences prior to service initiation, during an at-home telemedicine medical abortion visit, and after completing the medical abortion.

Results We interviewed 24 patients who obtained care via the at-home telemedicine medical abortion service. Patients selected at-home telemedicine due to convenience, ability to remain at home and manage personal responsibilities, and desires for privacy. A few telemedicine patients reported that a lack of general practitioner knowledge of abortion services impeded their access to care. Most telemedicine patients felt at-home telemedicine was of equal or superior privacy to in-person care and nearly all felt comfortable during the telemedicine visit. Most were satisfied with the home delivery of the abortion medications and would recommend the service.

Conclusion Patient reports suggest that an at-home telemedicine model for medical abortion is a convenient and acceptable mode of service delivery that may reduce patient travel and out-of-pocket costs. Additional provider education about this model may be necessary in order to improve continuity of patient care. Further study of the impacts of this model on patients is needed to inform patient care and determine whether such a model is appropriate for similar geographical and legal contexts.

  • abortion
  • service delivery
  • qualitative research
  • family planning service provision

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Footnotes

  • Contributors T-AT, CM and DM are responsible for conceptualisation and design of the study. MVS and JWS coordinated data collection. MVS conducted the in-depth interviews. LF and JWS analysed the data. LF, JWS and T-AT interpreted the data and drafted the manuscript. All authors have reviewed and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer This work was supported by an anonymous donor that had no role in study design, data collection, analysis or interpretation.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting, or dissemination plans of this research.

  • Ethics approval The study was registered with the Monash University Human Research Ethics Committee (8295) and ethical approval was granted by the Marie Stopes International Ethics Review Committee (020–16).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. Participants completed informed consent documents prior to participating in the study with the understanding that any and all identifying information would remain confidential, including in the context of publication. Publishing the complete dataset would infringe on the confidentiality agreement we have made with the participants in our study. Beyond the relevant data included in the manuscript, we are willing to share the research instrument upon request.

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