Work

Poster Abstracts

Year: 2021

Type: article

Abstract: Objectives: To estimate feasibility, acceptability, and effectiveness of medication abortion with mifepristone dispensed by mail-order pharmacy. Methods: We conducted a prospective cohort study at five clinical sites in four states from January 2020 through January 2021. Clinic personnel counseled pregnant patients ≤63 days’ gestation and planning to have a medication abortion, then consented those interested in receiving the medications by mail-order pharmacy. Clinicians sent electronic prescriptions to the pharmacy for mifepristone 200 mg orally and misoprostol 800 mcg buccally. Medications were express-shipped to patients’ preferred addresses. Participants received web-based surveys about their experience and outcomes on days 3 and 14 after enrollment with routine clinical follow-up. We extracted clinical data from medical records and performed descriptive analyses. Results: All enrolled participants (N=171) received their medications, usually within 3 days (n=149, 87%, range 1-14 days) of order placement. We obtained clinical outcome information for 162 (95%) participants, of whom 160 took the medications. Among those, 157 (98%) and 152 (89%) completed day 3 and day 14 surveys, respectively. 156 participants (98%, 95% CI 94-99%) had a complete abortion with medication alone; of those, 5 (3%) used a repeat dose of misoprostol. 4 (3%) participants underwent aspiration for ongoing pregnancy. There were 9 confirmed adverse events (all emergency visits, including one reported hospitalization); none were related to mail-order dispensing. Most participants reported being “very” or “somewhat” satisfied with mail-order dispensing (94%, n=151) and with the medication abortion (87%, n=139). Conclusions: Mail-order pharmacy dispensing of mifepristone for medication abortion is feasible, acceptable to patients, and effective.

Source: Contraception

DOI: 10.1016/j.contraception.2021.07.023