Telemedicine care yields comparable results to in-person care for medication abortions

A new study published in Obstetrics & Gynecology found fewer than 1% of women had clinically adverse events after a remote or in-person procedure.
By Laura Lovett
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A recent study published in Obstetrics & Gynecology found that women using telemedicine for a medication abortion had comparable outcomes to those accessing an in-person provider for care. 

In fact, researchers reported that the rate of ongoing pregnancy and aspiration procedures was lower in women who used the telemedicine services than in-person care. However, the team was quick to note this could be due to the lower follow-up rate of women using telemedicine.  

Medication-supported abortion involves taking two FDA-approved medications, called mifepristone and misoprostol, according to Planned Parenthood. The study was conducted by Planned Parenthood and funded by a grant from Susan T. Buffett Foundation. 

“Findings from this study conducted across geographically diverse settings support existing evidence that outcomes for medication abortion provided through telemedicine are comparable with standard provision of medication abortion,” the authors of the study wrote. 

TOPLINE DATA

In the group receiving telemedicine care, 0.5% had an ongoing pregnancy after the procedure, compared with 1.8% who received the standard of care. The study also found that a smaller percentage of women in the telemedicine group had an aspiration procedure following their medication abortion than the in-person group.

In both groups of patients, fewer than 1% of women had clinically adverse events after the procedure. However, it is important to note that women who had the telemedicine care were less likely to follow up (60.3%) than women who had the standard of care (76.9%).

“We found that rates of both ongoing pregnancy and aspiration procedures were higher in the standard group than in the telemedicine group. ... These differences could be due to lower proportion of telemedicine patients with follow-up data in the present study,” researchers wrote.

HOW IT WAS DONE

The researchers analyzed EHRs for patients receiving in-person care and those receiving and telemedicine care at 26 Planned Parenthood centers in Alaska, Idaho, Nevada and Washington. Patients went through the standard of care including on-site ultrasounds, lab testing and counseling, as well as either an in-person or remote consent meeting before the procedure. The study included a total of 5,952 women. Of that, 738 received telemedicine care and 5,214 received in-person care. 

THE BACKGROUND

Telemedicine for medication abortion has been a controversial subject in the U.S. In March, Arkansas’ House of Representatives voted down a bill to allow telemedicine for abortions. It’s on the docket for numerous other states. 

This isn’t the first study on telemedicine for medication abortions. In 2017, BMJ published an article looking at 1,000 women who underwent “self-sourced” medical abortions through a telemedicine service called Women on Web. In the study, 95% of women reported successful results. 

ON THE RECORD 

“In sum, this study provides additional evidence that telemedicine for medication abortion results in comparable outcomes with standard provision of medication abortion when implemented across different geographic settings. To the extent that state bans on telemedicine for abortion rest on arguments of improved patient safety, the findings of this and previous studies do not support such contentions,” researchers wrote in the article. "As more health care services, including abortion, become dependent on or facilitated by technology, future research should continue to assess the effects of telemedicine on patient experience and access to care."