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Study Reveals No-Test Telehealth Medication Abortion is as Effective and Safe as In-Person Care

June 27, 2024 — A recent study has shown that medication abortion using no-test telehealth screening and mailing of medications is as effective and safe as traditional in-person care with ultrasonography. This finding could significantly impact abortion care access in the United States.

The prospective, observational study, conducted between May 2021 and March 2023, involved 585 participants from abortion-providing organizations in six states: Colorado, Illinois, Maryland, Minnesota, Virginia, and Washington. The study aimed to evaluate the effectiveness and safety of medication abortion obtained through a no-test telehealth model compared to in-person care.

Key findings from the study include:

  • Effectiveness: The complete abortion rate for the no-test telehealth group was 94.4%, closely matching the 93.3% rate for the in-person care group. This difference met the prespecified noninferiority margin of 5%, indicating that the telehealth approach is not inferior to in-person care.
  • Safety: The prevalence of serious adverse events, such as overnight hospital admission, surgery, or blood transfusion, was low overall. The no-test telehealth group reported a 1.1% rate of such events, comparable to the in-person care group.

The study’s participants, who were seeking medication abortions up to 70 days’ gestation, were offered three models of care: no-test telehealth with mailed medications, no-test telehealth with medication pickup, and in-person care with ultrasonography. The majority of participants were non-Hispanic White (48.6%) or non-Hispanic Black (28.1%), with a mean age of 27.3 years.

These findings suggest that telehealth models relying on no-test eligibility assessments and mailing medications are a viable option for individuals considering medication abortion. This approach could enhance accessibility, especially in areas with limited access to in-person abortion services.

The importance of this study is underscored by the rapid growth of telehealth and mail-based medication abortion services in the US. The additional evidence provided by this study supports the effectiveness and safety of these innovative care models.

As policymakers and healthcare providers consider the implications of these findings, the potential to broaden access to safe and effective medication abortion through telehealth could lead to significant changes in reproductive healthcare delivery.

Reference: JAMA Network Journal.

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