title: Effectiveness and acceptability of medical abortion provided through telemedicine.
abstract: OBJECTIVE
  To estimate the effectiveness and acceptability of telemedicine provision of early medical abortion compared with provision with a face-to-face physician visit at a Planned Parenthood affiliate in Iowa.
  
  
  METHODS
  Between November 2008 and October 2009, we conducted a prospective cohort study of women obtaining medical abortion by telemedicine or face-to-face physician visits. We collected clinical data, and women completed a self-administered questionnaire at follow-up. We also compared the prevalence of reportable adverse events between the two service delivery models among all patients seen between July 2008 and October 2009.
  
  
  RESULTS
  Of 578 enrolled participants, follow-up data were obtained for 223 telemedicine patients and 226 face-to-face patients. The proportion with a successful abortion was 99% for telemedicine patients (95% confidence interval [CI] 96-100%) and 97% for face-to-face patients (95% CI 94-99%). Ninety-one percent of all participants were very satisfied with their abortion, although in multivariable analysis, telemedicine patients had a higher odds of saying they would recommend the service to a friend compared with face-to-face patients (odds ratio, 1.72; 95% CI 1.26-2.34). Twenty-five percent of telemedicine patients said they would have preferred being in the same room with the doctor. Younger age, less education, and nulliparity were significantly associated with preferring face-to-face communication. There was no significant difference in the prevalence of adverse events reported during the study period among telemedicine patients (n = 1,172) (1.3%; 95% CI 0.8-2.1%) compared with face-to-face patients (n = 2,384) (1.3%; 95% CI 0.9-1.8%) (82% power to detect difference of 1.3%).
  
  
  CONCLUSIONS
  Provision of medical abortion through telemedicine is effective and acceptability is high among women who choose this model.
  
  
  METHODS
  II.
authors.affiliation: From Ibis Reproductive Health, Oakland, California, and Cambridge, Massachusetts; the Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California; Planned Parenthood of the Heartland, Des Moines, Iowa; Abortion Access Project, Cedar Rapids, Iowa.
authors.forename: Daniel
authors.initials: D
authors.lastname: Grossman
authors.forename: Kate
authors.initials: K
authors.lastname: Grindlay
authors.forename: Todd
authors.initials: T
authors.lastname: Buchacker
authors.forename: Kathleen
authors.initials: K
authors.lastname: Lane
authors.forename: Kelly
authors.initials: K
authors.lastname: Blanchard
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage; D000028:Abortion, Induced / Q000009:adverse effects; D000278:Administration, Buccal; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D015735:Mifepristone / Q000008:administration & dosage; D016595:Misoprostol / Q000008:administration & dosage; D017060:Patient Satisfaction; D011247:Pregnancy; D017216:Telemedicine; D014837:Voluntary Health Agencies; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D016595:Misoprostol; D015735:Mifepristone