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P025Mail-order pharmacy dispensing of mifepristone for medication abortion after in-person clinical assessment

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      Objectives

      To investigate the acceptability, feasibility, and effectiveness of dispensing medications for abortion using a mail-order pharmacy following an in-person assessment.

      Methods

      We conducted a prospective cohort study of patients seeking medication abortion services at 11 sites in seven states. Patients interested in and eligible for medication abortion provided consent. Clinicians electronically sent prescribed mifepristone and misoprostol to the mail-order pharmacy, which shipped these medications to participants’ preferred addresses. Participants completed web-based surveys about their experience and outcomes three days and 14 days post-enrollment and had routine clinical follow-up. Clinic staff extracted clinical data from medical records. We performed descriptive analyses to assess outcomes of interest.

      Results

      Between January 2020 and April 2022, 408 participants enrolled, of which three enrolled for two abortions (total sample: 411 pregnancies among 408 participants). Among the 94% (388/411) who took the medications and for whom clinical outcome data were obtained, 85% (329/388) received the medications within three days, 0.8% (3/388) took mifepristone beyond 70 days’ gestation, and 1.6% (6/388) did not take misoprostol as indicated. Complete medication abortion occurred in 380 cases (97.9%, CI, 96.0–99.1); among the others, 1.8% (7/388) were treated with aspiration and one continued the pregnancy. Almost all, 98% (380/388) and 94% (366/388) completed the day 3 and day 14 surveys, respectively; and reported they were somewhat or very satisfied with mail-order dispensing (96%, 365/380) and the medication abortion overall (92%, 338/366). No adverse events related to mail-order dispensing occurred.

      Conclusions

      Mail-order pharmacy dispensing of mifepristone for medication abortion is safe, feasible, acceptable, and effective for patients.
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