Article ; Online: Implications of using home urine pregnancy tests versus facility-based tests for assessment of outcome following medication abortion provided via telemedicine.
2023 Volume 124, Page(s) 110055
Abstract: Objectives: To assess whether planning high-sensitivity urine pregnancy tests (HSPT) rather than facility-based tests for medication abortion follow-up may increase risk of unplanned clinical visits or procedural completion of the abortion.: Study ... ...
| Abstract | Objectives: To assess whether planning high-sensitivity urine pregnancy tests (HSPT) rather than facility-based tests for medication abortion follow-up may increase risk of unplanned clinical visits or procedural completion of the abortion. Study design: We used data from the TelAbortion Project, a 5-year study assessing the safety and feasibility of providing mifepristone and misoprostol by telemedicine and mail in the United States. We categorized participants by whether the pretreatment follow-up plan included HSPT at home 3-5 weeks after treatment or facility-based tests (ultrasound or serum human chorionic gonadotropin) within 2 weeks after treatment. We used multivariable logistic regression to compare likelihood of post-treatment unplanned, abortion-related clinical visits and procedural intervention in these groups. Results: Of 1324 patients who planned HSPT follow-up and 576 who planned facility-based tests, 85% and 83%, respectively, provided outcome information. Post-treatment clinical visits were less frequent in the HSPT group (19%) than in the facility-based test group (79%); most of the latter were to obtain the planned test. However, unplanned, abortion-related visits were significantly more common in the HSPT group (adjusted risk difference: 6.5%; p < 0.01). The likelihood of procedural completion did not differ by group. Planned follow-up test was not associated with delay in procedural completion or detection of ongoing pregnancy. Conclusions: Follow-up of medication abortion with home HSPT was associated with fewer post-treatment clinical visits, modestly more unplanned, abortion-related clinical visits, and no increase in the risk of procedural interventions or delayed identification or management of treatment failures. This option is an appropriate follow-up approach after medication abortion. Implications: Use of home high-sensitivity pregnancy tests rather than facility-based tests for outcome assessment after medication abortion is associated with a modest increase in unplanned clinical visits but does not lead to an increase in procedural interventions or delays identification and management of treatment failure. |
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| MeSH term(s) | Pregnancy ; Female ; Humans ; United States ; Abortion, Induced ; Mifepristone/therapeutic use ; Misoprostol/therapeutic use ; Pregnancy Tests ; Telemedicine |
| Chemical Substances | Mifepristone (320T6RNW1F) ; Misoprostol (0E43V0BB57) |
| Language | English |
| Publishing date | 2023-04-23 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 80106-9 |
| ISSN | 1879-0518 ; 0010-7824 |
| ISSN (online) | 1879-0518 |
| ISSN | 0010-7824 |
| DOI | 10.1016/j.contraception.2023.110055 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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