Tomnay Jane E, Coelli Lauren, Davidson Ange, Hulme-Chambers Alana, Orr Catherine, Hocking Jane S
Centre for Excellence in Rural Sexual Health (CERSH), University of Melbourne, Department of Rural Health, 49 Graham Street, Shepparton, VIC 3630, Australia.
Clinic 35, Gateway Health Wodonga, 155 High Street, Wodonga, VIC 3690, Australia.
Sex Reprod Healthc. 2018 Jun;16:175-180. doi: 10.1016/j.srhc.2018.04.006. Epub 2018 Apr 11.
To describe how a nurse led, MToP service is run in primary care in regional Victoria and investigate the characteristics and contraceptive choices of the women who have attended.
Descriptive study of the development and implementation of a rural MToP service and a retrospective chart audit of patients attending between January 2015 and September 2016.
Characteristics and clinical outcomes for women attending an MToP service in a primary care setting in rural Victoria. Contraceptive usage pre and post attending a rural service for MToP.
There were 229 presentations, representing 223 women, of which 172 women (75.1%; 95%CI: 69.0%, 80.6%) had a successful MToP and for two further women, MToP failed, requiring a surgical termination (0.9%; 95%CI: 0.1%, 3.1%). At the time of presentation, the mean age of women was 25 years, the median length of gestation was 49 days and 171 (75%) had not had a previous termination. Data about contraceptive use was available for 195 women, 143 (73.3%) reported no contraception, 2 reported emergency contraceptive pill (1.0%), 10 used condoms (2.1%) and 39 (20.0%) reported hormonal contraception. Among the 156 women using no contraception, condoms or emergency contraception at the time of pregnancy, 113 (72.4%) initiated a reliable form of contraception post presentation to the MToP service.
Provision of accessible, affordable MToP through an integrated primary health service is one strategy to address access inequity in regional areas.
描述在维多利亚州农村地区基层医疗中由护士主导的药物流产服务（MToP）的运作方式，并调查前来就诊的女性的特征和避孕选择。
对一项农村MToP服务的开展和实施进行描述性研究，并对2015年1月至2016年9月期间就诊的患者进行回顾性病历审核。
在维多利亚州农村地区基层医疗环境中接受MToP服务的女性的特征和临床结局。在农村地区接受MToP服务前后的避孕使用情况。
共有229人次就诊，代表223名女性，其中172名女性（75.1%；95%可信区间：69.0%，80.6%）药物流产成功，另有2名女性药物流产失败，需要进行手术终止妊娠（0.9%；95%可信区间：0.1%，3.1%）。就诊时，女性的平均年龄为25岁，妊娠中位数时长为49天，171名（75%）女性此前未曾终止过妊娠。有195名女性的避孕使用数据，143名（73.3%）报告未采取避孕措施，2名报告使用紧急避孕药（1.0%），10名使用避孕套（2.1%），39名（20.0%）报告使用激素避孕法。在怀孕时未采取避孕措施、使用避孕套或紧急避孕药的156名女性中，113名（72.4%）在就诊于MToP服务后开始采用可靠的避孕方式。
通过综合性基层医疗服务提供可及且负担得起的药物流产服务是解决农村地区医疗服务可及性不平等问题的一项策略。
