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P033Patient acceptability of asynchronous vs synchronous telehealth medication abortion care in the US

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      Objectives

      Despite its recent expansion in the US, little is known about patient experiences with direct-to-patient telehealth abortion care and its role in addressing inequities in access to care.

      Methods

      We analyzed surveys from patients of three US virtual abortion clinics — Choix, Hey Jane, and Abortion on Demand — who received care between April 2021 and January 2022. We described telehealth abortion experiences and used logistic regression to evaluate inequities by race/ethnicity and by whether the patient communicated with the provider by video (synchronous) or messaging (asynchronous).

      Results

      Across the 1,306 included participants, nearly all (98%) felt they could trust the telehealth provider, 95% said that telehealth abortion was the right experience for them, and 89% were very satisfied. Participants cited privacy (93%) and the ability to get the abortion pills quickly (91%) as benefits. The most common drawbacks were concerns about whether the service was legitimate (37%), not confirming the abortion outcome at a clinic (23%), and not having a screening ultrasound (21%). Compared to white participants, Asian participants were less likely to be very satisfied with their care (OR, 0.5; 95% CI, 0.3–1.0). We found no other differences by race/ethnicity. While patients who received synchronous care were more likely to report that telehealth was right for them (OR, 2.6; 95% CI, 1.0–6.3), we found no differences in satisfaction and trust by communication method.

      Conclusions

      Telehealth abortion care is highly acceptable, and its benefits include privacy and expediency. However, there may be some differences by race/ethnicity that warrant further exploration.
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