Contraception 2024;134(June) https://doi.org/10.1016/j.contraception.2024.110406
(not open access)
by JL Cely Andrade, K Cárdenas Garzón, LC Enríquez Santander, B Saavedra Avendaño, G Ortiz Avendano
Introduction: Access to abortion like a voluntary decision is a topic with a high impact on women’s health and health systems around the world in general. with the objective of demonstrate the effectiveness, security, and efficacy of a national program for medical abortion in a middle-income country without legal barriers for the procedure in women of all ages with less than 24 weeks of gestation, a retrospective analysis where done. this analysis includes the comparison between two services modalities comparison; telehealth and presential attention, the main outcomes included were, effectiveness, follow-up, and adverse events.
Method: This was a retrospective cohort study (August 1, 2021, to August 31, 2022) conducted with 23,362 women who requested Profamilia’s medical abortion service. This service was provided via telemedicine to 3,073 women (13.2%) and in person to 20,289 women (86.8%). We measured the following outcomes: follow-up consultation, successful medical abortion without surgical intervention, non-serious adverse events, complications, satisfaction with the service, time elapsed from initial consultation to start of treatment, and assessment of depressive disorder using the Patient Health Questionnaire (PHQ-9). We performed the statistical analysis by comparing proportions with the Chi-square test of independence or the Fisher’s exact test, as applicable, and by comparing medians with the Mann–Whitney U test.
Results: Complete abortion without surgical intervention and adverse events were the outcomes with the best results for telemedicine. Complications were less frequent in women who received the service in person. There were no differences between the two modalities regarding the follow-up consultation and satisfaction with the service outcomes. Most users of the in-person modality were classified with mild depression according to the PHQ-9.
Conclusions
Telemedicine is an effective and safe option for medical abortion. Its results are similar to or better than those of in-person care.