Gynuity Health Projects, New York, NY, United States.
Gynuity Health Projects, New York, NY, United States.
Contraception. 2024 Mar;131:110340. doi: 10.1016/j.contraception.2023.110340. Epub 2023 Nov 20.
This study aimed to assess the feasibility, safety, and acceptability of asynchronous screening for medication abortion eligibility using a programmed questionnaire.
For this study, we developed an informational website about medication abortion with a linked questionnaire programmed to produce a conclusion regarding eligibility according to standard criteria. We enrolled people in Colorado and Minnesota who submitted questionnaires indicating eligibility. A study physician reviewed each questionnaire and medical records if available and determined whether the responses warranted treatment without a synchronous clinical consultation or ultrasound. If so, the physician prescribed a standard regimen of mifepristone and misoprostol. We collected posttreatment data on abortion outcome, adverse events, and satisfaction.
We received questionnaires from 197 individuals, of whom 160 remained in the study until the physician made a final treatment decision. Physicians prescribed medication abortion to 156 (97.5%) individuals based on the questionnaire responses, whereas four needed further assessment to confirm eligibility. Of the 156 individuals, 130 had sufficient follow-up to assess abortion outcome, and 123 (95%) had complete medication abortions without additional treatment. One participant was hospitalized for bleeding, and one expelled a 15-week fetus; however, it is not clear that conventional synchronous history-based screening would have averted these events. Of the 197 questionnaires, 42% were submitted outside business hours. On satisfaction questionnaires, 134 (96%) of 144 participants said they would recommend the study to a friend who needed an abortion.
Data from this pilot project suggest that providing medication abortion based only on a self-administered, programmed questionnaire is likely to be effective, safe, efficient, and acceptable.
A programmed self-administered patient questionnaire to assess eligibility for medication abortion could reduce the cost of the service, augment clinic efficiency, improve quality of care, and enhance access to abortion.
本研究旨在评估使用编程问卷对药物流产资格进行异步筛查的可行性、安全性和可接受性。
在这项研究中，我们开发了一个关于药物流产的信息网站，并链接了一个编程问卷，以根据标准标准产生关于资格的结论。我们招募了在科罗拉多州和明尼苏达州提交表明有资格参加问卷调查的人。一名研究医生审查了每一份问卷和可用的医疗记录，如果有必要，确定是否需要治疗而无需同步临床咨询或超声检查。如果是这样，医生就会开出米非司酮和米索前列醇的标准方案。我们收集了流产结局、不良事件和满意度的治疗后数据。
我们收到了 197 份问卷，其中 160 份在医生做出最终治疗决定之前仍留在研究中。根据问卷回答，医生为 156 名（97.5%）个人开出了药物流产处方，而 4 名需要进一步评估以确认资格。在 156 名个体中，有 130 名有足够的随访来评估流产结局，123 名（95%）个体无需额外治疗就完成了药物流产。一名参与者因出血而住院，一名参与者排出了一个 15 周大的胎儿；然而，目前尚不清楚传统的基于同步病史的筛查是否可以避免这些事件。在 197 份问卷中，有 42%是在工作时间以外提交的。在满意度问卷中，134 名（96%）的 144 名参与者表示会向需要堕胎的朋友推荐该研究。
本试点项目的数据表明，仅根据自我管理的编程问卷提供药物流产很可能是有效、安全、高效和可接受的。
一个用于评估药物流产资格的编程自我管理患者问卷可以降低服务成本，提高诊所效率，改善护理质量，并增加堕胎机会。
