{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:45:30Z","timestamp":1793036730360,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T00:00:00Z","timestamp":1616544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare outcomes before and after implementation of medical abortion (termination of pregnancy) without ultrasound via telemedicine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cohort analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The three main abortion providers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population or sample<\/jats:title>\n                    <jats:p>\n                      Medical abortions at home at \u226469\u00a0days\u2019 gestation in two cohorts: traditional model (in\u2010person with ultrasound,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a022\u00a0158) from January to March 2020 versus telemedicine\u2010hybrid model (either in person or via telemedicine without ultrasound,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a029\u00a0984, of whom 18\u00a0435 had no\u2010test telemedicine) between April and June 2020. Sample (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a052\u00a0142) comprises 85% of all medical abortions provided nationally.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from electronic records and incident databases were used to compare outcomes between cohorts, adjusted for baseline differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Treatment success, serious adverse events, waiting times, gestation at treatment, acceptability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean waiting time from referral to treatment was 4.2\u00a0days shorter in the telemedicine\u2010hybrid model and more abortions were provided at \u22646\u00a0weeks\u2019 gestation (40% versus 25%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Treatment success (98.8% versus 98.2%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&gt;\u00a00.999), serious adverse events (0.02% versus 0.04%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.557) and incidence of ectopic pregnancy (0.2% versus 0.2%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.796) were not different between models. In the telemedicine\u2010hybrid model, 0.04% were estimated to be over 10\u00a0weeks\u2019 gestation at the time of the abortion; all were completed safely at home. Within the telemedicine\u2010hybrid model, effectiveness was higher with telemedicine than in\u2010person care (99.2% versus 98.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Acceptability of telemedicine was high (96% satisfied) and 80% reported a future preference for telemedicine.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A telemedicine\u2010hybrid model for medical abortion that includes no\u2010test telemedicine and treatment without an ultrasound is effective, safe, acceptable and improves access to care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Tweetable abstract<\/jats:title>\n                    <jats:p>Compelling evidence from 52\u00a0142 women shows no\u2010test telemedicine abortion is safe, effective and improves care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.16668","type":"journal-article","created":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T23:33:30Z","timestamp":1613691210000},"page":"1464-1474","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":239,"title":["Effectiveness, safety and acceptability of no\u2010test medical abortion (termination of pregnancy) provided via telemedicine: a national cohort study"],"prefix":"10.1111","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1555-3025","authenticated-orcid":false,"given":"ARA","family":"Aiken","sequence":"first","affiliation":[{"name":"LBJ School of Public Affairs University of Texas at Austin Austin TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1862-5730","authenticated-orcid":false,"given":"PA","family":"Lohr","sequence":"additional","affiliation":[{"name":"British Pregnancy Advisory Service Stratford upon Avon UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2819-5973","authenticated-orcid":false,"given":"J","family":"Lord","sequence":"additional","affiliation":[{"name":"MSI Reproductive Choices London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Ghosh","sequence":"additional","affiliation":[{"name":"National Unplanned Pregnancy Advisory Service (NUPAS) Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4765-360X","authenticated-orcid":false,"given":"J","family":"Starling","sequence":"additional","affiliation":[{"name":"Mathematica Policy Research Cambridge MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30315-6"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32753-8"},{"key":"e_1_2_7_4_1","volume-title":"Abortion Care. 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