Effectiveness and Acceptability of Medical Abortion Provided Through Telemedicine
Effectiveness and Acceptability of Medical Abortion Provided Through Telemedicine
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DOI：
10.1097/aog.0b013e318224d110
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发表时间：
2011-08-01
影响因子：
7.2
通讯作者：
Blanchard, Kelly
中科院分区：
文献类型：
--
作者：
Grossman, Daniel;Grindlay, Kate;Blanchard, Kelly
目的：为了估计早期药物流产的远程医疗提供的有效性和可接受性相比，提供面对面的医生访问计划生育附属机构在爱荷华州.METHODS：2008年11月至2009年10月，我们进行了一项前瞻性队列研究的妇女获得药物流产的远程医疗或面对面的医生访问。我们收集了临床数据，女性在随访时完成了一份自填问卷。我们还比较了2008年7月至2009年10月期间所有患者中两种服务提供模式之间可报告不良事件的发生率。结果：在578名入组参与者中，获得了223名远程医疗患者和226名面对面患者的随访数据。远程医疗患者成功流产的比例为99%（95%置信区间[CI] 96-100%），面对面患者为97%（95% CI 94-99%）。91%的参与者对他们的堕胎非常满意，尽管在多变量分析中，与面对面的患者相比，远程医疗患者有更高的几率说他们会向朋友推荐这项服务（比值比，1.72; 95%CI 1.26-2.34）。25%的远程医疗患者表示，他们更愿意与医生在同一个房间。年轻，教育程度低，未生育与更喜欢面对面的沟通显着相关。在研究期间，远程医疗患者报告的不良事件发生率没有显著差异（人数= 1 172）（1.3%; 95% CI 0.8-2.1%）与面对面患者相比（n = 2，384）（1.3%; 95%CI 0.9-1.8%）（82%把握度检测差异为1.3%）.结论：通过远程医疗提供药物流产是有效的，选择这种模式的妇女的可接受性很高。（妇产科2011;118：296-303）DOI：10.1097/AOG.0b013e318224d110
OBJECTIVE: 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.METHODS: 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.RESULTS: 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%).CONCLUSION: Provision of medical abortion through telemedicine is effective and acceptability is high among women who choose this model. (Obstet Gynecol 2011;118:296-303) DOI: 10.1097/AOG.0b013e318224d110