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An observational study of patient experiences with a direct-to-patient telehealth abortion model in Australia
  1. Terri-ann Thompson1,
  2. Jane W Seymour1,
  3. Catriona Melville2,
  4. Zara Khan3,
  5. Danielle Mazza4,
  6. Daniel Grossman5
  1. 1 Ibis Reproductive Health, Cambridge, Massachusetts, USA
  2. 2 Marie Stopes Australia, Melbourne, Victoria, Australia
  3. 3 The University of Texas Southwestern Medical Center Medical School, Dallas, Texas, USA
  4. 4 Department of General Practice, Monash University, Notting Hill, Victoria, Australia
  5. 5 Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, Oakland, California, USA
  1. Correspondence to Dr Terri-ann Thompson, Ibis Reproductive Health, Cambridge, MA 02140, USA; tthompson{at}ibisreproductivehealth.org

Abstract

Background While abortion care is widely legal in Australia, access to care is often poor. Many Australians must travel long distances or interstate to access abortion care, while others face stigma when seeking care. Telehealth-at-home medical abortion is a potential solution to these challenges. In this study, we compared the experience of accessing an abortion via telehealth-at-home to accessing care in-clinic.

Methods Over a 20-month period, we surveyed patients who received medical abortion services at Marie Stopes Australia via the telehealth-at-home service or in-clinic. We conducted bivariate analyses to assess differences in reported acceptability and accessibility by delivery model.

Results In total, 389 patients were included in the study: 216 who received medical abortion services in-clinic and 173 through the telehealth-at-home service. Telehealth-at-home and in-clinic patients reported similarly high levels of acceptability: satisfaction with the service (82% vs 82%), provider interaction (93% vs 84%), and recommending the service to a friend (73% vs 72%). Only 1% of telehealth-at-home patients reported that they would have preferred to be in the same room as the provider. While median time between discovering the pregnancy to first contact with a clinic was similar between groups, median time from first contact to taking the first abortion medication was 7 days longer for telehealth-at-home patients versus in-clinic patients (14 days (IQR 9–21) vs 7 days (IQR 4–14); p<0.01).

Conclusion The telehealth-at-home medical abortion service has the potential to address some of the challenges with provision of abortion care in Australia.

  • health services accessibility
  • patient satisfaction
  • reproductive health services
  • surveys and questionnaires
  • abortion
  • induced
  • patient preference

Data availability statement

Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding authorupon reasonable request.

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Data availability statement

Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding authorupon reasonable request.

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Footnotes

  • Twitter @DrDGrossman

  • Contributors TT, CM, DM and DG were responsible for study conceptualisation and design. JWS and TT coordinated data collection. ZK and TT analysed the data. TT, ZK, CM and JWS interpreted the data and drafted the manuscript. All authors reviewed and approved the manuscript.

  • Funding 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, or conduct, or reporting, or dissemination plans of this research.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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