COMPARISON OF SAFETY AND EFFICACY BETWEEN TELEMEDICINE AND CLINIC-BASED MEDICATION ABORTION AT A SINGLE ACADEMIC CENTER

Objectives

Despite the rise in telemedicine medication abortion rates in the US, there is limited evidence comparing this model (NTMA) to traditional clinic-based medication abortion (CBMA). We aim to further the evidence around safety and efficacy of telemedicine medication abortion by comparing NTMA to CBMA to address the growing demand for abortion access.

Methods

We conducted a retrospective cohort study comparing safety and efficacy outcomes using electronic medical records for patients who either had a CBMA(n=800) or NTMA(n=171) up to 77 days of gestation between June 1, 2018 and December 31, 2022, at a large academic health center in California. Secondary outcomes included comparing completion rates of post-treatment follow-up and assessing the four-week home pregnancy test results for NTMA patients.

Results

A total of 91% of CBMA and 92% of NTMA patients had successful abortions without surgical intervention (p>0.05). After controlling for covariates, successful abortion rates did not statistically significantly differ by modality [adjusted OR (aOR) 1.10, p>0.05]. Less than 1% of both groups experienced an adverse event (p>0.05), with no missed ongoing or missed ectopic pregnancies for either modality. A greater proportion of NTMA patients completed a first follow-up visit compared to CBMA patients, although this difference was not statistically significant [aOR 1.78, p>0.05]. Approximately 18% of NTMA patients had positive pregnancy tests at a four-week follow-up appointment.

Conclusions

NTMA is an equally safe and effective abortion care model as CBMA. If not already offered, the provision of telemedicine medication abortion should be considered to meet the growing demand for abortion access.