{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T18:42:52Z","timestamp":1757616172741,"version":"3.44.0"},"reference-count":30,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2023,11,29]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess patient experiences of pain management during medical abortion up to 10 weeks\u2019 gestation with opt-in versus universal codeine provision.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We invited patients who underwent medical abortion up to 10 weeks of gestation to participate in an online, anonymous, English-language survey from November 2021 to March 2022. We performed ordinal regression analyses to compare satisfaction with pain management (5-point Likert scale) and maximum abortion pain score (11-point numerical rating scale) in the opt-in versus universal codeine provision groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 11\u2009906 patients invited to participate, 1625 (13.6%) completed the survey. Participants reported a mean maximum pain score of 6.8\u00b12.2. A total of 1149 participants (70.7%) reported using codeine for pain management during their abortion. Participants in the opt-in codeine provision group were significantly more likely to be satisfied with their pain management than those in the universal group (aOR 1.48, 95%\u2009CI 1.12 to 1.96, p&lt;0.01). Maximum abortion pain scores were lower on average among the opt-in codeine provision group (OR 0.80, 95%\u2009CI 0.66 to 0.96, p=0.02); however, this association was not statistically significant in the model adjusted for covariates (aOR 0.85, 95%\u2009CI 0.70 to 1.03, p=0.09).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our findings suggest that patients have a better experience with pain management during medical abortion when able to opt-in to codeine provision following counselling versus receiving this medication routinely.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2023-201893","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T01:15:31Z","timestamp":1706663731000},"page":"114-121","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Opt-in versus universal codeine provision for medical abortion up to 10 weeks of gestation at British Pregnancy Advisory Service: a cross-sectional evaluation"],"prefix":"10.1136","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2646-0390","authenticated-orcid":false,"given":"Neda","family":"Taghinejadi","sequence":"first","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5006-967X","authenticated-orcid":false,"given":"Hannah","family":"McCulloch","sequence":"additional","affiliation":[{"name":"Centre for Reproductive Research & Communication, British Pregnancy Advisory Service, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9638-7785","authenticated-orcid":false,"given":"Micha\u0142","family":"Krassowski","sequence":"additional","affiliation":[{"name":"Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0520-6174","authenticated-orcid":false,"given":"Amelia","family":"McInnes-Dean","sequence":"additional","affiliation":[{"name":"Centre for Reproductive Research & Communication, British Pregnancy Advisory Service, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3283-3803","authenticated-orcid":false,"given":"Katherine C","family":"Whitehouse","sequence":"additional","affiliation":[{"name":"Centre for Reproductive Research & Communication, British Pregnancy Advisory Service, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1862-5730","authenticated-orcid":false,"given":"Patricia A","family":"Lohr","sequence":"additional","affiliation":[{"name":"Centre for Reproductive Research & Communication, British Pregnancy Advisory Service, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,1,30]]},"reference":[{"key":"2025090510291181000_50.2.114.1","doi-asserted-by":"publisher","DOI":"10.1001\/archfami.7.4.360"},{"key":"2025090510291181000_50.2.114.2","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.contraception.2022.03.003","article-title":"The experience of pain in real-time during medication abortion","volume":"110","author":"Friedlander","year":"2022","journal-title":"Contraception"},{"key":"2025090510291181000_50.2.114.3","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31829d5a33"},{"key":"2025090510291181000_50.2.114.4","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1080\/13625187.2017.1315092","article-title":"Assessment of pain during medical abortion with home use of misoprostol","volume":"22","author":"Cavet","year":"2017","journal-title":"Eur J Contracept Reprod Health Care"},{"key":"2025090510291181000_50.2.114.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.01.084"},{"key":"2025090510291181000_50.2.114.6","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1111\/j.1471-0528.2005.00638.x","article-title":"A randomised controlled trial of mifepristone in combination with misoprostol administered sublingually or vaginally for medical abortion up to 13 weeks of gestation","volume":"112","author":"Hamoda","year":"2005","journal-title":"BJOG"},{"key":"2025090510291181000_50.2.114.7","unstructured":"Reynolds-Wright JJ , Woldetsadik MA , Morroni C , et al . 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