{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T06:52:57Z","timestamp":1779346377445,"version":"3.51.4"},"reference-count":32,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2023,2,12]]},"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>To determine whether clinical outcomes differ among women accessing a combined medical abortion regimen from a health clinic when compared with those accessing it from a pharmacy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a multicentre, prospective, comparative, non-inferiority study of participants aged \u226515 years seeking medical abortion from five clinics and five adjacent pharmacy clusters in three provinces of Cambodia. Participants were recruited in-person at the point of purchase (clinic or pharmacy). Follow-up for self-reported pill use, acceptability, and clinical outcomes occurred by telephone at days 10 and 30 after mifepristone administration.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Over 10 months, we enrolled 2083\u2009women with 1847 providing outcome data: 937 from clinics and 910 from pharmacies. Most were early in their pregnancy (mean gestational age of 6.3 and 6.1 weeks, respectively) and almost all took the pills correctly (98% and 96%,). Additional treatment needed to complete the abortion was non-inferior for the pharmacy group (9.3%) compared with the clinic group (12.7%). More from the clinic group received additional care from a provider, such as antibiotics or diagnostics tests, than those from the pharmacy group (11.5% and 3.2%,), and one ectopic pregnancy (pharmacy group) was successfully treated. Most said they felt prepared for what happened after taking the pills (90.9% and 81.3%, respectively, p=0.273).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Self-use of a combined medical abortion product resulted in comparable clinical outcomes as use following a clinical visit, consistent with existing literature on its safety and efficacy. Registration and availability of medical abortion as an over-the-counter product would likely increase women\u2019s access to safe abortion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2022-201722","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T13:21:21Z","timestamp":1678368081000},"page":"300-307","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["A prospective, comparative study of clinical outcomes following clinic-based versus self-use of medical abortion"],"prefix":"10.1136","volume":"49","clinical-trial-number":[{"clinical-trial-number":"nct03727308","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9602-3674","authenticated-orcid":false,"given":"Nathalie","family":"Kapp","sequence":"first","affiliation":[{"name":"Ipas, Chapel Hill, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bunsoth","family":"Mao","sequence":"additional","affiliation":[{"name":"University of Health Sciences, Phnom Penh, Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie","family":"Menzel","sequence":"additional","affiliation":[{"name":"Ipas, Chapel Hill, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Eckersberger","sequence":"additional","affiliation":[{"name":"Ipas, Chapel Hill, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vonthanak","family":"Saphonn","sequence":"additional","affiliation":[{"name":"University of Health Sciences, Phnom Penh, Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tung","family":"Rathavy","sequence":"additional","affiliation":[{"name":"Ministry of Health, Phnom Penh, Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Pearson","sequence":"additional","affiliation":[{"name":"Ipas, Chapel Hill, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,3,9]]},"reference":[{"key":"2025090510152314000_49.4.300.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31794-4"},{"key":"2025090510152314000_49.4.300.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh-2018-200149"},{"key":"2025090510152314000_49.4.300.3","doi-asserted-by":"crossref","DOI":"10.2471\/BLT.14.136333","article-title":"From concept to measurement: operationalizing WHO\u2019s definition of unsafe abortion","volume":"92","author":"Ganatra","year":"2014","journal-title":"Bull World Health Organ"},{"key":"2025090510152314000_49.4.300.4","doi-asserted-by":"crossref","DOI":"10.1186\/s12905-020-01003-8","article-title":"Medical termination for pregnancy in early first trimester (\u2264 63 days) using combination of mifepristone and misoprostol or misoprostol alone: a systematic review","volume":"20","author":"Abubeker","year":"2020","journal-title":"BMC Womens Health"},{"key":"2025090510152314000_49.4.300.5","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000897"},{"key":"2025090510152314000_49.4.300.6","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.contraception.2017.09.006","article-title":"Efficacy of medical abortion prior to 6 gestational weeks: a systematic review","volume":"97","author":"Kapp","year":"2018","journal-title":"Contraception"},{"key":"2025090510152314000_49.4.300.7","article-title":"Medical methods for first trimester abortion","volume":"2011","author":"Kulier","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"2025090510152314000_49.4.300.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2012.06.011"},{"key":"2025090510152314000_49.4.300.9","unstructured":"World Health Organization . 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