{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T16:09:45Z","timestamp":1768925385049,"version":"3.49.0"},"reference-count":20,"publisher":"BMJ","issue":"2","funder":[{"name":"This work was supported by an anonymous donor that had no role in study design, data collection, analysis or interpretation","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2021,9,6]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>While abortion care is widely legal in Australia, access to care is often poor. Many Australians must travel long distances or interstate to access abortion care, while others face stigma when seeking care. Telehealth-at-home medical abortion is a potential solution to these challenges. In this study, we compared the experience of accessing an abortion via telehealth-at-home to accessing care in-clinic.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Over a 20-month period, we surveyed patients who received medical abortion services at Marie Stopes Australia via the telehealth-at-home service or in-clinic. We conducted bivariate analyses to assess differences in reported acceptability and accessibility by delivery model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 389 patients were included in the study: 216 who received medical abortion services in-clinic and 173 through the telehealth-at-home service. Telehealth-at-home and in-clinic patients reported similarly high levels of acceptability: satisfaction with the service (82% vs 82%), provider interaction (93% vs 84%), and recommending the service to a friend (73% vs 72%). Only 1% of telehealth-at-home patients reported that they would have preferred to be in the same room as the provider. While median time between discovering the pregnancy to first contact with a clinic was similar between groups, median time from first contact to taking the first abortion medication was 7 days longer for telehealth-at-home patients versus in-clinic patients (14 days (IQR 9\u201321) vs 7 days (IQR 4\u201314); p&lt;0.01).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The telehealth-at-home medical abortion service has the potential to address some of the challenges with provision of abortion care in Australia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2021-201259","type":"journal-article","created":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T13:28:54Z","timestamp":1631798934000},"page":"103-109","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["An observational study of patient experiences with a direct-to-patient telehealth abortion model in Australia"],"prefix":"10.1136","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3570-6500","authenticated-orcid":false,"given":"Terri-ann","family":"Thompson","sequence":"first","affiliation":[{"name":"Ibis Reproductive Health, Cambridge, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane W","family":"Seymour","sequence":"additional","affiliation":[{"name":"Ibis Reproductive Health, Cambridge, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5891-0259","authenticated-orcid":false,"given":"Catriona","family":"Melville","sequence":"additional","affiliation":[{"name":"Marie Stopes Australia, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zara","family":"Khan","sequence":"additional","affiliation":[{"name":"The University of Texas Southwestern Medical Center Medical School, Dallas, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6158-7376","authenticated-orcid":false,"given":"Danielle","family":"Mazza","sequence":"additional","affiliation":[{"name":"Department of General Practice, Monash University, Notting Hill, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3221-9368","authenticated-orcid":false,"given":"Daniel","family":"Grossman","sequence":"additional","affiliation":[{"name":"Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, Oakland, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,9,16]]},"reference":[{"key":"2025090512271178000_48.2.103.1","unstructured":"Children by Choice Association Incorporated . Australian abortion law and practice. Available: https:\/\/www.childrenbychoice.org.au\/factsandfigures\/australianabortionlawandpractice [Accessed 22 Jan 2021]."},{"key":"2025090512271178000_48.2.103.2","unstructured":"Children by Choice Association Incorporated . Medication abortion. Available: https:\/\/www.childrenbychoice.org.au\/foryou\/abortion\/medicationabortion [Accessed 4 Jun 2021]."},{"key":"2025090512271178000_48.2.103.3","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/ajr.12096","article-title":"Rural New South Wales women's access to abortion services: highlights from an exploratory qualitative study","volume":"22","author":"Doran","year":"2014","journal-title":"Aust J Rural Health"},{"key":"2025090512271178000_48.2.103.4","doi-asserted-by":"crossref","DOI":"10.1186\/s12910-019-0346-1","article-title":"Conscientious objection to abortion, the law and its implementation in Victoria, Australia: perspectives of abortion service providers","volume":"20","author":"Keogh","year":"2019","journal-title":"BMC Med Ethics"},{"key":"2025090512271178000_48.2.103.5","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1111\/j.1467-842X.2006.tb00844.x","article-title":"Travel undertaken by women accessing private Victorian pregnancy termination services","volume":"30","author":"Nickson","year":"2006","journal-title":"Aust N Z J Public Health"},{"key":"2025090512271178000_48.2.103.6","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1111\/1753-6405.12641","article-title":"Access, equity and costs of induced abortion services in Australia: a cross-sectional study","volume":"41","author":"Shankar","year":"2017","journal-title":"Aust N Z J Public Health"},{"key":"2025090512271178000_48.2.103.7","unstructured":"Agency for Healthcare Research and Quality (AHRQ) . Digital healthcare research Archive: telehealth. Available: https:\/\/digital.ahrq.gov\/key-topics\/telehealth [Accessed 22 Jan 2021]."},{"key":"2025090512271178000_48.2.103.8","article-title":"Telehealth services in rural and remote Australia: a systematic review of models of care and factors influencing success and sustainability","volume":"16","author":"Bradford","year":"2016","journal-title":"Rural Remote Health"},{"key":"2025090512271178000_48.2.103.9","unstructured":"Institute of Medicine (US) Committee on Evaluating Clinical Applications of Telemedicine In: Field MJ Telemedicine: a guide to assessing telecommunications in health care (The National Academies Collection: reports funded by National Institutes of Health). Washington (DC): National Academies Press (US), 1996. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK45448\/"},{"key":"2025090512271178000_48.2.103.10","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.9.4.e33"},{"key":"2025090512271178000_48.2.103.11","unstructured":"Given LM . The SAGE encyclopedia of qualitative research methods. Thousand Oaks, CA: SAGE Publications Inc., 2021. https:\/\/us.sagepub.com\/en-us\/nam\/the-sage-encyclopedia-of-qualitative-research-methods\/book229805"},{"key":"2025090512271178000_48.2.103.12","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1111\/ajo.12800","article-title":"A direct-to-patient telemedicine abortion service in Australia: retrospective analysis of the first 18 months","volume":"58","author":"Hyland","year":"2018","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"2025090512271178000_48.2.103.13","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh-2020-200612"},{"key":"2025090512271178000_48.2.103.14","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.contraception.2019.05.013","article-title":"TelAbortion: evaluation of a direct to patient telemedicine abortion service in the United States","volume":"100","author":"Raymond","year":"2019","journal-title":"Contraception"},{"key":"2025090512271178000_48.2.103.15","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15684"},{"key":"2025090512271178000_48.2.103.16","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1071\/HC19050","article-title":"'I didn't feel judged': exploring women's access to telemedicine abortion in rural Australia","volume":"12","author":"Ireland","year":"2020","journal-title":"J Prim Health Care"},{"key":"2025090512271178000_48.2.103.17","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.contraception.2019.12.008","article-title":"\"We've got rights and yet we don't have access\": exploring patient experiences accessing medication abortion in Australia","volume":"101","author":"LaRoche","year":"2020","journal-title":"Contraception"},{"key":"2025090512271178000_48.2.103.18","doi-asserted-by":"crossref","first-page":"515","DOI":"10.2147\/PPA.S197015","article-title":"What is the most important factor affecting patient satisfaction \u2013 a study based on gamma coefficient","volume":"13","author":"Fang","year":"2019","journal-title":"Patient Prefer Adherence"},{"key":"2025090512271178000_48.2.103.19","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318224d110"},{"key":"2025090512271178000_48.2.103.20","unstructured":"Seymour JW , Snow J , Garnsey C . Patient satisfaction with telemedicine for medication abortion: survey data from seven US states: 8."}],"container-title":["BMJ Sexual &amp; Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsrh-2021-201259","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T19:27:22Z","timestamp":1757100442000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1136\/bmjsrh-2021-201259"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,16]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,4,8]]},"published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1136\/bmjsrh-2021-201259"],"URL":"https:\/\/doi.org\/10.1136\/bmjsrh-2021-201259","relation":{},"ISSN":["2515-1991","2515-2009"],"issn-type":[{"value":"2515-1991","type":"print"},{"value":"2515-2009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,16]]}}}