Medication abortion via telemedicine in primary care found to be effective, trustworthy

Key takeaways:

• Participants said TeleMAB was straightforward and provided greater flexibility in their lives.
• TeleMAB also helped to normalize abortion care within primary care.

Telemedicine medication abortion services in primary care were well received by patients thanks to clear communication and previously established relationships, researchers found.

According to Amy Tressan, MD, from the department of family medicine at Planned Parenthood of Orange and San Bernadino counties in California, and colleagues, several primary care clinics implemented telemedicine medication abortion (TeleMAB) services during the COVID-19 pandemic.

In this type of care, patients receive medications through the mail after consulting with clinicians over video or by telephone.

“While there are studies looking at medication abortion safety and acceptability both in person within primary care as well as for stand-alone telehealth medication abortion services, we felt there was a paucity of research looking specifically at the novel service of telehealth medication abortion within primary care networks,” Tressan told Healio.

The researchers gained greater insight into patients’ perspectives of TeleMAB by conducting telephone interviews with 14 English, Spanish or Portuguese-speaking participants who received care between July 2020 and December 2021.

The respondents were aged 26 to 42 years, 42.8% identified as Black individuals and 71.4% had children aged 8 months to 15 years.

Overall, “participants felt provider counseling prepared them well and expressed confidence in having necessary information to successfully complete their abortion,” Tressan and colleagues wrote in the Annals of Family Medicine.

Existing relationships within the primary care network helped participants to feel more comfortable receiving care from doctors who were not their primary care provider.

“Their trust extended from their provider to the health system,” the researchers wrote. “When difficult situations arose, established relationships with one’s PCP helped mitigate the impact.”

Participants noted that TeleMAB supported their ability “to exercise control, autonomy, and flexibility” and resulted in:

• decreased interruptions during daily life;
• increased agency over surroundings; and
• greater accessibility to coping mechanisms, which helped to decrease anxiety.

TeleMAB also helped normalize abortion care; participants’ first instincts when they missed their periods was to call their primary care provider, whereas care at an independent abortion clinic seemed more isolating.

“In a hostile political climate that has politicized basic medical care, it is important to normalize it by integrating these services as routine health care, which it is!” Tressan said. “Integrating medication abortion into routine health care will normalize it as another medical service that should be provided in primary care practices, and can help take the burden off independent clinics and can reduce appointment delays for out-of-state patients seeking care.”

The researchers pointed out that respondents with more positive experiences may have been more likely to participate in interviews than those with negative experiences, while further research is needed to determine how TeleMAB would affect abortion equity for historically underrepresented groups.

“It is imperative that we demonstrate the necessity of abortion care and how providing it in its different forms within primary care networks can help grant needed access to more people,” Tressan said.