Early medical abortion provision via telehealth in Victoria: A qualitative descriptive stud
Year: 2024
Type: article
Abstract: Background and objectiveLittle is known about the views of service providers currently working in telehealth early medical abortion (EMA) provision in Victoria, Australia.This study aims to contextualise the enablers and barriers to telehealth EMA provision, providing insight for healthcare policy and practice to improve the accessibility of this service. MethodsThis was a qualitative descriptive study involving semistructured interviews with 14 Victorian stakeholders with expertise and knowledge on telehealth EMA provision.Data were analysed using conventional content analysis. ResultsThis study presents perceived enablers and barriers across four different contexts of the Victorian abortion system: (1) perceived patient context; (2) perceived provider context;(3) health organisation-system context; and (4) sociopolitical context.The COVID-19 pandemic's disruption of healthcare services led to greater patient and provider acceptance of telehealth EMA.However, barriers within the patient context included the inability to ensure safety and confidentiality, digital access and literacy issues, language barriers, and the importance of trusting provider-patient relationships.Providers encountered challenges in delivering holistic care via telehealth, including time and workload issues and working with interpreters.Shortcomings within the organisational context encompassed structural barriers for culturally and linguistically diverse population groups, the absence of standard telehealth guidelines and varying interpretations of telehealth.Although temporary Medicare item number changes improved access, they presented financial challenges for mixed and private billing practices. DiscussionThe application of these findings by relevant health services and policymakers has the potential to improve the quality of, and increase accessibility to, telehealth EMA, better meeting the needs of individuals seeking this service.EARLY MEDICAL ABORTION (EMA) involves the oral intake of medical abortifacients in the form of MS-2 Step: mifepristone and misoprostol.1EMA can be delivered through a face-to-face consultation or via telehealth up until nine weeks gestation.1 In Australia, telehealth for EMA was first initiated in 2015 by the Tabbott Foundation and, subsequently, Marie Stopes International. 2 Telehealth services enabled Australians to access EMA in their homes without a visit to a medical practitioner and significantly increased access for people in rural and regional settings.3 The uptake and integration of telehealth EMA into mainstream Australian primary care has been slow and fragmented. 2 Telehealth EMA within general practice was previously inaccessible for most people until the COVID-19 pandemic.As a result of the pandemic, there was an increase in the uptake of telehealth in healthcare and the implementation of Medicare Benefits Schedule (MBS) telehealth item numbers that allowed general practitioners (GPs) to bulk bill telehealth EMA consultations. 4 Since this policy change, little research has been undertaken to explore the benefits and challenges of telehealth EMA being provided through the primary healthcare system.Previous studies that have sought to evaluate the use of telehealth EMA in Australia have focused on the experiences of patients who have accessed this service.3,[5][6][7] As a result, little is known about the views and experiences of individuals working in telehealth EMA service provision in Australia.As such, given the strong movement towards providing EMA within primary care settings, the aim of this study was to understand the barriers and enablers to providing telehealth EMA, as perceived by stakeholders working in this area in Victoria. MethodsA qualitative descriptive approach with semi-structured interviews was used to obtain rich, detailed, contextual descriptions of a range of enablers and barriers surrounding telehealth EMA provision directly from study participants.8 Setting and sampling strategyThe population of interest was stakeholders (defined as individuals with expertise or knowledge on the topic of telehealth EMA) who were experts in EMA provision Early medical abortion provision via telehealth in Victoria: A qualitative descriptive study
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4404122339