Acceptability of no-test medical abortion provided via telemedicine during Covid-19: analysis of patient-reported outcomes
Acceptability of no-test medical abortion provided via telemedicine during Covid-19: analysis of patient-reported outcomes
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DOI：
10.1136/bmjsrh-2020-200954
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发表时间：
2021-10-01
影响因子：
3.3
通讯作者：
Church, Kathryn
中科院分区：
文献类型：
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作者：
Erlank, Chelsey Porter;Lord, Jonathan;Church, Kathryn
英国政府于2020年3月30日批准了两个阶段的早期药物流产（EMA），使用米非司酮和米索前列醇，用于10周以下的妊娠。英国最大的堕胎服务提供商之一MSI Reproductive Choices UK（MSUK）于2020年4月6日推出了一项无需测试的远程医疗EMA途径。本研究的目的是报告关键的患者报告结局指标，并评估我们的样本是否代表接受未经测试的远程医疗EMA的整个人群。方法邀请2020年4月至8月期间所有MSUK远程医疗EMA患者的样本参加随访电话，以回答临床和满意度问题。共有1243例（占所有远程医疗EMA的13.7%）成功随访，平均在术后5天内。结果患者对远程医疗EMA有很高的信心，对在家管理流产的便利性、隐私性和易用性有很高的满意度。答复的样本大致相当于接受远程医疗的全体人口。没有患者报告他们无法私下咨询。大多数（1035，83%）患者报告更喜欢远程医疗途径，824（66%）表示如果COVID-19不再是一个问题，他们会再次选择远程医疗。结论远程医疗EMA是一种有价值的，私人的，方便的和更容易获得的选择，是高度接受的患者寻求堕胎，特别是那些在诊所访问是后勤或情感上的挑战。有证据表明，这一途径将是大多数患者在未来再次首选支持的情况下，使远程医疗EMA永久。
Introduction The English government approved both stages of early medical abortion (EMA), using mifepristone and misoprostol under 10 weeks' gestation, for at-home use on 30 March 2020. MSI Reproductive Choices UK (MSUK), one of the largest providers of abortion services in England, launched a no-test telemedicine EMA pathway on 6 April 2020. The objectives of this study were to report key patient-reported outcome measures and to assess whether our sample was representative of the whole population receiving no-test telemedicine EMA. Methods A sample of all MSUK's telemedicine EMA patients between April and August 2020 were invited to opt in to a follow-up call to answer clinical and satisfaction questions. A total of 1243 (13.7% of all telemedicine EMAs) were successfully followed-up, on average within 5 days post-procedure. Results Patients reported high confidence in telemedicine EMA and high satisfaction with the convenience, privacy and ease of managing their abortion at home. The sample responding were broadly equivalent to the whole population receiving telemedicine. No patient reported that they were unable to consult privately. The majority (1035, 83%) of patients reported preferring the telemedicine pathway, with 824 (66%) indicating that they would choose telemedicine again if COVID-19 were no longer an issue. Conclusions Telemedicine EMA is a valued, private, convenient and more accessible option that is highly acceptable for patients seeking an abortion, especially those for whom in-clinic visits are logistically or emotionally challenging. Evidence that this pathway would be a first choice again in future for most patients supports the case to make telemedicine EMA permanent.