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Objectives
To understand how patients decide whether to choose direct-to-patient telehealth or
in-clinic services for medication abortion care.
Methods
This qualitative study used in-depth, semi-structured interviews collected from September
2021 to January 2022 and analyzed using inductive-deductive constant comparative analysis.
We conducted 30 one-on-one, one-hour remote interviews with participants who received
a medication abortion from a high-volume reproductive healthcare clinic in Washington
State (20 telehealth, 10 in-clinic). Outcomes included clinic and patient sociodemographic
and psychological factors from the Patient Choice and Empowerment Framework. Interviews
were recorded, transcribed, and quality checked; major themes were identified and
summarized.
Results
The majority of those interviewed were aged 30–35 (56.7%) and half were in the first
six weeks of their pregnancy at time of care (50.0%). Six individuals (20%) self-identified
as Hispanic/Latino, five (17%) as Non-Hispanic White, and 10 (33%) as Non-Hispanic,
other race. How soon a clinic appointment was available was the most important consideration
for choosing modality of care, with high value placed on same-day or next-day appointments.
Participants preferred telehealth services to in-person services due to (1) convenience,
(2) less disruption from other responsibilities at home or work, (3) familiarity of
telehealth due to increased use during the COVID-19 pandemic, and (4) less stigmatization
of being in-person. Participants who chose in-clinic services over telehealth options
did so to ensure their care was legitimate.
Conclusions
Both telehealth and in-clinic medication abortion services meet different patient
needs. Providing patients with a choice about modality for care meets these diverse
needs and allows for more accessible and satisfactory services.
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Copyright
© 2022 Published by Elsevier Inc.
