title: A prospective, non-randomized study of home use of mifepristone for medical abortion in the U.S.
abstract: OBJECTIVE
  To determine the acceptability of taking mifepristone at home for early medical abortion in the United States.
  
  
  METHODS
  This prospective, non-randomized, open-label study at six Planned Parenthood centers gave women with pregnancies up to 63 days' gestation seeking medical abortion the choice of taking mifepristone in the center or at home. Participants were interviewed at a follow-up visit 1-2 weeks after mifepristone administration to assess their experience with the option they selected.
  
  
  RESULTS
  Four-hundred women were enrolled between April 2013 and June 2014 of which 32% (n=128) chose to take mifepristone at home. Abortion success rates did not differ between home and center users (96% and 97%). Among home users, 82% reported taking the mifepristone at the time they planned with their provider and no participant took it after 63 days' gestation. The most common reason cited for selecting home use was scheduling flexibility and significantly more home users took misoprostol on the weekend (50% vs. 36%, p=.02). Home users were more likely than center users to report missing no days of work due to the abortion (47% vs. 28%, p=.08). Ninety-nine percent of home users reported that they would take mifepristone at home again and 96% would recommend home use to a friend. Offering this option did not increase the service delivery burden on study providers, who would recommend home use in the future for most participants.
  
  
  CONCLUSIONS
  Home use of mifepristone is a highly acceptable practice for which there is current demand, and it should be offered as part of routine medical abortion services.
  
  
  CONCLUSIONS
  Offering the option of home use of mifepristone to medical abortion patients can provide women and clinics with more flexibility while maintaining a safe, effective and acceptable service. These results provide support for telemedicine or pharmacy distribution.
authors.affiliation: Gynuity Health Projects, 15 East 26th Street, 8th Floor, New York, NY 10010, USA. Electronic address: echong@gynuity.org.
authors.forename: Erica
authors.initials: E
authors.lastname: Chong
authors.affiliation: Gynuity Health Projects, 15 East 26th Street, 8th Floor, New York, NY 10010, USA. Electronic address: lfrye@gynuity.org.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Frye
authors.affiliation: Planned Parenthood of Northern New England, 90 Washington Street, Barre, VT 05641, USA; Planned Parenthood of Northern New England, 183 St. Paul Street, Burlington, VT 05401, USA; Planned Parenthood of Northern New England, 6 Roberts North, Rutland, VT 05701, USA. Electronic address: Jen.castle@ppfa.org.
authors.forename: Jen
authors.initials: J
authors.lastname: Castle
authors.affiliation: Planned Parenthood of New York City, 26 Bleecker Street, New York, NY 10012, USA. Electronic address: Gillian.dean@ppnyc.org.
authors.forename: Gillian
authors.initials: G
authors.lastname: Dean
authors.affiliation: Planned Parenthood of the Great Northwest and Hawaii, 402 Legion Way, Suite 201, Olympia, WA 98501, USA; Planned Parenthood of the Great Northwest and Hawaii, 702-30th Avenue Southwest, Puyallup, WA 98373, USA. Electronic address: laurel.kuehl@ppgnw.org.
authors.forename: Laurel
authors.initials: L
authors.lastname: Kuehl
authors.affiliation: Gynuity Health Projects, 15 East 26th Street, 8th Floor, New York, NY 10010, USA. Electronic address: bwinikoff@gynuity.org.
authors.forename: Beverly
authors.initials: B
authors.lastname: Winikoff
mesh_terms: D000019:Abortifacient Agents / Q000008:administration & dosage*; D000028:Abortion, Induced; D000293:Adolescent; D000328:Adult; D002755:Choice Behavior; D005260:Female; D006801:Humans; D015735:Mifepristone / Q000008:administration & dosage*; D016595:Misoprostol / Q000008:administration & dosage*; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011446:Prospective Studies; D012646:Self Administration; D014481:United States; D055815:Young Adult
chemical_list: D000019:Abortifacient Agents; D016595:Misoprostol; D015735:Mifepristone
keywords: Acceptability; Home use; Medical abortion; Mifepristone; Self-administration