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P012Acceptability of self-managed medication abortion using misoprostol-alone provided via a hybrid telemedicine and pharmacy pick-up model in the US

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      Objectives

      To examine the acceptability of self-managed medication abortion using misoprostol-alone acquired from an online or local pharmacy in the US.

      Methods

      Between November and December 2021, we conducted 32 semi-structured in-depth interviews with individuals who used misoprostol-alone to self-manage an abortion in June 2020. We recruited participants from Aid Access, an online telemedicine organization that provided self-managed abortion assistance and prescriptions for misoprostol from a local or online pharmacy for eligible people in all 50 states. Interviews were transcribed and thematically coded to assess individual satisfaction with acquiring and using misoprostol.

      Results

      Participants were initially hesitant to trust Aid Access, but having a pharmacy prescription sent by a physician legitimized the service. From internet searches and previous abortion experiences, participants had extensive knowledge of misoprostol's efficacy and utility. Participants who used the in-person pharmacy pick-up model had both confidence in the familiarity of the process and concerns about intrusive questioning from the pharmacist. Although rare, some did experience pharmacist pushback or refusal. Participants who used the online pharmacy model were concerned about shipping times but had positive and informative interactions with the pharmacists. Across both models, participants desired more extensive options for emotional support.

      Conclusions

      Participants had high levels of knowledge about misoprostol and familiarity with the pharmacy as a healthcare institution. Despite some unmet emotional needs and negative encounters with pharmacists, overall, this process was acceptable to participants and has the potential to expand medication abortion access in the restrictive policy landscape of the US.
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