July 2020

At-home telemedicine for medical abortion in Australia: A qualitative study of patient experiences and recommendations

Fix L, Seymour J, Sandhu M, Melville C, Mazza D, Thompson T-A. At-home telemedicine for medical abortion in Australia: A qualitative study of patient experiences and recommendations. BMJ. July 2020. http://dx.doi.org/10.1136/ bmjsrh-2020-200703

Introduction: This study aimed to explore patient experiences obtaining a medical abortion using an at-home telemedicine service operated by Marie Stopes Australia.

Methods: From July to October 2017, we conducted semistructured in-depth telephone interviews with a convenience sample of medical abortion patients from Marie Stopes Australia. We analysed interview data for themes relating to patient experiences prior to service initiation, during an at-home telemedicine medical abortion visit, and after completing the medical abortion.

Results: We interviewed 24 patients who obtained care via the at-home telemedicine medical abortion service. Patients selected at-home telemedicine due to convenience, ability to remain at home and manage personal responsibilities, and desires for privacy. A few telemedicine patients reported that a lack of general practitioner knowledge of abortion services impeded their access to care. Most telemedicine patients felt at-home telemedicine was of equal or superior privacy to in-person care and nearly all felt comfortable during the telemedicine visit. Most were satisfied with the home delivery of the abortion medications and would recommend the service.

Conclusion: Patient reports suggest that an athome telemedicine model for medical abortion is a convenient and acceptable mode of service delivery that may reduce patient travel and outof-pocket costs. Additional provider education about this model may be necessary in order to improve continuity of patient care. Further study of the impacts of this model on patients is needed to inform patient care and determine whether such a model is appropriate for similar geographical and legal contexts.