title: RU OK? The acceptability and feasibility of remote technologies for follow-up after early medical abortion.
abstract: OBJECTIVE
  We tested the effectiveness and feasibility of remote communication technologies to increase follow-up after early medical abortion.
  
  
  METHODS
  Women (n=999) were randomized to 'remote' follow-up incorporating a low-sensitivity pregnancy test and standardized symptom questionnaire administered online, by text message or telephone by a non-clinical call center operator 2 weeks after treatment, or to 'clinic-based' follow-up with ultrasound at 1 week. Women in the clinic-based group who could not return performed a high-sensitivity pregnancy test at 3 weeks and had a telephone call with clinic staff. The primary outcome was completion of follow-up. Rates of complications, acceptability and preferences were compared.
  
  
  RESULTS
  The overall follow-up rate did not differ by group {clinic-based, 73% vs. remote, 69%; risk ratio (RR) 1.0 [95% confidence interval (CI) 0.9-1.2]}. In the clinic-based group, 83% did not return for an ultrasound scan and were followed up by phone. In the remote group, follow-up by phone or text was more successful than online (text: 75.4%; phone: 73.7%; online: 46.5%, p<.001). The proportion of women receiving additional care was 9% in the clinic-based group and was 4% in the remote group [RR 1.8 (95% CI 1.1-3.1)]. Most women found their follow-up method acceptable but would prefer follow-up by phone or text message if needed in future.
  
  
  CONCLUSIONS
  Follow-up after medical abortion using remote communication is feasible and, for most women, preferable to a clinic visit.
  
  
  CONCLUSIONS
  Medical abortion protocols typically use follow-up visits to ensure early identification of complications. This study demonstrates that follow-up can be achieved using remote communication technologies. This model may reduce the burden of multiple clinic visits on patients and providers.
authors.affiliation: Gynuity Health Projects, 15 East 26th Street #Suite 801, New York, NY 10010, USA.
authors.forename: Hillary
authors.initials: H
authors.lastname: Bracken
authors.affiliation: British Pregnancy Advisory Service, 20 Timothy's Bridge Road, Stratford Enterprise Park, Stratford-upon-Avon, Warwickshire CV37 9BF, UK. Electronic address: patricia.lohr@bpas.org.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Lohr
authors.affiliation: British Pregnancy Advisory Service, 20 Timothy's Bridge Road, Stratford Enterprise Park, Stratford-upon-Avon, Warwickshire CV37 9BF, UK.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Taylor
authors.affiliation: British Pregnancy Advisory Service, 20 Timothy's Bridge Road, Stratford Enterprise Park, Stratford-upon-Avon, Warwickshire CV37 9BF, UK.
authors.forename: Chelsea
authors.initials: C
authors.lastname: Morroni
authors.affiliation: Gynuity Health Projects, 15 East 26th Street #Suite 801, New York, NY 10010, USA.
authors.forename: Beverly
authors.initials: B
authors.lastname: Winikoff
mesh_terms: D000028:Abortion, Induced / Q000379:methods*; D000293:Adolescent; D000328:Adult; D003142:Communication; D016001:Confidence Intervals; D003283:Contraceptives, Postcoital, Synthetic / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015735:Mifepristone / Q000008:administration & dosage*; D017060:Patient Satisfaction; D011247:Pregnancy; D011795:Surveys and Questionnaires; D013689:Telephone; D060145:Text Messaging; D006113:United Kingdom; D055815:Young Adult
chemical_list: D003283:Contraceptives, Postcoital, Synthetic; D015735:Mifepristone
keywords: Acceptability; Low-sensitivity pregnancy test; Mifepristone; Telephone; Text message