Department of Obstetrics, Gynecology & Reproductive Sciences, Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, University of California, Oakland, California.
Department of Obstetrics, Gynecology & Reproductive Sciences, Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, University of California, Oakland, California.
Womens Health Issues. 2021 May-Jun;31(3):227-235. doi: 10.1016/j.whi.2021.02.007. Epub 2021 Apr 5.
Utah law requires patients to have a face-to-face "informed consent" visit at least 72 hours prior to abortion. Planned Parenthood Association of Utah (PPAU) offers this visit via telemedicine as an alternative to an in-person visit, which can require burdensome travel. This novel study identifies factors associated with using telemedicine for informed consent, patients' reasons for using it, and experiences with it, compared to in-person informed consent.
In 2017 and 2018, patients 18 years and older seeking abortion at PPAU completed a self-administered online survey about their experiences with the informed consent visit. We used linear and logistic regression models to compare participants' demographic characteristics by informed consent visit type, and descriptive statistics to describe reasons for using each visit type and experiences with the visit. Multivariable logistic regression models examined associations between visit type and satisfaction.
Responses from 166 telemedicine patients and 217 in-person informed consent patients indicate that telemedicine participants would have had to travel significantly further than in-person participants traveled to attend the visit at the clinic (mean of 65 miles versus 21 miles, p < .001). In multivariable analyses, telemedicine participants had higher odds of being "very satisfied" with the visit (aOR, 2,89; 95% CI: 1.93-4.32) and "very comfortable" asking questions during the visit (aOR, 3.76; 95% CI: 2.58-5.49), compared to participants who attended in-person visits.
Telemedicine offers a convenient, acceptable option for mandated pre-abortion informed consent visits and reduces the burden of additional travel and associated barriers for some patients, particularly those who live further away from clinics.
犹他州法律要求患者在堕胎前至少 72 小时进行面对面的“知情同意”访问。犹他州计划生育协会（PPAU）通过远程医疗提供这种访问，作为面对面访问的替代方案，这可能需要繁琐的旅行。这项新颖的研究确定了与使用远程医疗进行知情同意相关的因素、患者使用它的原因以及与面对面知情同意相比的使用体验。
在 2017 年和 2018 年，在 PPAU 寻求堕胎的 18 岁及以上患者完成了一项关于他们在知情同意访问方面的经历的自我管理在线调查。我们使用线性和逻辑回归模型比较了参与者在知情同意访问类型方面的人口统计学特征，并使用描述性统计数据描述了每种访问类型的使用原因和访问体验。多变量逻辑回归模型研究了访问类型与满意度之间的关联。
来自 166 名远程医疗患者和 217 名面对面知情同意患者的回应表明，远程医疗参与者必须比面对面参与者旅行更远才能参加在诊所进行的访问（平均距离为 65 英里，而面对面参与者为 21 英里，p < 0.001）。在多变量分析中，与参加面对面访问的参与者相比，远程医疗参与者对访问“非常满意”的可能性更高（优势比，2.89；95%置信区间：1.93-4.32），并且在访问期间“非常舒适”地提问的可能性更高（优势比，3.76；95%置信区间：2.58-5.49）。
远程医疗为强制性堕胎前知情同意访问提供了一个方便、可接受的选择，并减少了一些患者额外旅行和相关障碍的负担，特别是那些距离诊所较远的患者。
