Abstract
Objectives
Compare proportion lost to follow-up, successful abortion, and staff effort in women
who choose office or telephone-based follow-up evaluation for medical abortion at
a teaching institution.
Study design
We performed a chart review of all medical abortions provided in the first three years
of service provision. Women receiving mifepristone and misoprostol could choose office
follow-up with an ultrasound evaluation one to two weeks after mifepristone or telephone
follow-up with a scheduled telephone interview at one week post abortion and a second
telephone call at four weeks to review the results of a home urine pregnancy test.
Results
Of the 176 medical abortion patients, 105 (59.7%) chose office follow-up and 71 (40.3%)
chose telephone follow-up. Office evaluation patients had higher rates of completing
all required follow-up compared to telephone follow-up patients (94.3% vs 84.5%, respectively,
p=.04), but proportion lost to follow-up was similar in both groups (4.8% vs 5.6%, respectively,
p=1.0). Medical abortion efficacy was 94.0% and 92.5% in women who chose office and
telephone follow-up, respectively. We detected two (1.2%) ongoing pregnancies, both
in the office group. Staff rescheduled 15.0% of appointments in the office group.
For the telephone follow-up cohort, staff made more than one phone call to 43.9% and
69.4% of women at one week and four weeks, respectively.
Conclusions
Proportion lost to follow-up is low in women who have the option of office or telephone
follow-up after medical abortion. Women who choose telephone-based evaluation compared
to office follow-up may require more staff effort for rescheduling of contact, but
overall outcomes are similar.
Implications
Although women who choose telephone evaluation may require more rescheduling of contact
as compared to office follow-up, having alternative follow-up options may decrease
the proportion of women who are lost to follow-up.
Keywords
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Article info
Publication history
Published online: April 18, 2016
Accepted:
April 12,
2016
Received in revised form:
April 11,
2016
Received:
March 2,
2016
Footnotes
☆Presented in part as an oral abstract at the 2015 North American Forum on Family Planning, Chicago, IL.
☆☆Conflicts of Interest: Dr. Mitchell Creinin is a consultant for Danco Laboratories. The other authors do not have any conflicts of interest to disclose.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
