Opt-in versus universal codeine provision for medical abortion up to 10 weeks of gestation at British Pregnancy Advisory Service: a cross-sectional evaluation.

IF 3.4 3区 医学 Q1 FAMILY STUDIES BMJ Sexual & Reproductive Health Pub Date : 2024-04-11 DOI:10.1136/bmjsrh-2023-201893
Neda Taghinejadi, Hannah McCulloch, Michał Krassowski, Amelia McInnes-Dean, Katherine C Whitehouse, Patricia A Lohr
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Abstract

Objective: To assess patient experiences of pain management during medical abortion up to 10 weeks' gestation with opt-in versus universal codeine provision.

Methods: We invited patients who underwent medical abortion up to 10 weeks of gestation to participate in an online, anonymous, English-language survey from November 2021 to March 2022. We performed ordinal regression analyses to compare satisfaction with pain management (5-point Likert scale) and maximum abortion pain score (11-point numerical rating scale) in the opt-in versus universal codeine provision groups.

Results: Of 11 906 patients invited to participate, 1625 (13.6%) completed the survey. Participants reported a mean maximum pain score of 6.8±2.2. A total of 1149 participants (70.7%) reported using codeine for pain management during their abortion. Participants in the opt-in codeine provision group were significantly more likely to be satisfied with their pain management than those in the universal group (aOR 1.48, 95% CI 1.12 to 1.96, p<0.01). Maximum abortion pain scores were lower on average among the opt-in codeine provision group (OR 0.80, 95% CI 0.66 to 0.96, p=0.02); however, this association was not statistically significant in the model adjusted for covariates (aOR 0.85, 95% CI 0.70 to 1.03, p=0.09).

Conclusion: Our findings suggest that patients have a better experience with pain management during medical abortion when able to opt-in to codeine provision following counselling versus receiving this medication routinely.

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英国妊娠咨询服务机构为妊娠 10 周以内的药物流产提供可待因的选择性与普遍性:横断面评估。
目的评估患者在妊娠 10 周以内药物流产过程中选择提供可待因还是普遍提供可待因的疼痛管理经验:我们邀请妊娠 10 周以内接受药物流产的患者参与 2021 年 11 月至 2022 年 3 月期间的匿名在线英语调查。我们进行了序数回归分析,比较了选择提供可待因组和普遍提供可待因组的疼痛管理满意度(5 点李克特量表)和最大流产疼痛评分(11 点数字评分量表):在受邀参与调查的 11 906 名患者中,1625 人(13.6%)完成了调查。参与者报告的平均最大疼痛评分为 6.8±2.2。共有 1149 名参与者(70.7%)表示在流产过程中使用了可待因止痛。选择提供可待因组的参与者对疼痛控制满意度明显高于普通组(aOR 1.48,95% CI 1.12 至 1.96,pConclusion):我们的研究结果表明,与常规接受可待因药物治疗相比,如果患者能够在咨询后选择接受可待因药物治疗,他们在药物流产过程中的疼痛治疗体验会更好。
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来源期刊
BMJ Sexual & Reproductive Health
BMJ Sexual & Reproductive Health Medicine-Reproductive Medicine
CiteScore
5.10
自引率
6.10%
发文量
38
期刊介绍: BMJ Sexual & Reproductive Health is a multiprofessional journal that promotes sexual and reproductive health and wellbeing, and best contraceptive practice, worldwide. It publishes research, debate and comment to inform policy and practice, and recognises the importance of professional-patient partnership.
期刊最新文献
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