{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:11:44Z","timestamp":1791983504652,"version":"4.4.0"},"reference-count":29,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T00:00:00Z","timestamp":1728432000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017017","name":"Swedish Agency for Health Technology Assessment and Assessment of Social Services","doi-asserted-by":"crossref","award":["SBU: S2021\/05342"],"award-info":[{"award-number":["SBU: S2021\/05342"]}],"id":[{"id":"10.13039\/501100017017","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2024,9,13]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In many countries, persons seeking medical abortion with mifepristone followed by misoprostol can self-administer the second drug, misoprostol, at home, but self-administration of the first drug, mifepristone, is not allowed to the same extent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>This systematic review aims to evaluate whether the efficacy, safety and women\u2019s satisfaction with abortion treatment are affected when mifepristone is self-administered at home instead of in a clinic.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Search strategy<\/jats:title>\n                  <jats:p>A literature search covered CINAHL, Cochrane Library, Embase, Ovid MEDLINE and APA PsycInfo in October 2022.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Selection criteria<\/jats:title>\n                  <jats:p>Eligible studies focused on persons undergoing medical abortion comparing home and in-clinic mifepristone intake. Outcomes included abortion effectiveness, compliance, acceptability, and practical consequences for women.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data collection and analysis<\/jats:title>\n                  <jats:p>Two reviewers independently assessed eligibility and risk of bias. Meta-analysis included similar studies while those differing in design were synthesised without meta-analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Six studies (54 233\u2009women) of medical abortions up to 10 weeks were included. One randomised controlled trial and one retrospective register study had moderate risk of bias, and four non-randomised clinical trials where women could choose the place for intake of mifepristone had serious risk of bias. There was no difference in abortion effectiveness (high confidence) or compliance (moderate confidence) between mifepristone administered at home or in-clinic. No differences in complications were detected between groups and most women who chose home administration of mifepristone expressed a preference for this approach.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our systematic review demonstrates that the effectiveness of medical abortion is comparable regardless of mifepristone administration and intake, at home or in the clinic.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2024-202302","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T13:20:16Z","timestamp":1728480016000},"page":"221-231","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Home use of mifepristone for medical abortion: a systematic review"],"prefix":"10.1136","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6516-1444","authenticated-orcid":false,"given":"Kristina","family":"Gemzell-Danielsson","sequence":"first","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0673-3841","authenticated-orcid":false,"given":"Ingela","family":"Lindh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sahlgrenska Academy at Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Brynhildsen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, Link\u00f6ping University, Linkoping, Sweden"},{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine and Health, School of Medical Sciences, Faculty of Health and Medicine, \u00d6rebro University, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Christensson","sequence":"additional","affiliation":[{"name":"Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2054-6193","authenticated-orcid":false,"given":"Klas","family":"Moberg","sequence":"additional","affiliation":[{"name":"Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Wernersson","sequence":"additional","affiliation":[{"name":"Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0073-6355","authenticated-orcid":false,"given":"Susanne","family":"Johansson","sequence":"additional","affiliation":[{"name":"Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,10,9]]},"reference":[{"key":"2025090511104872000_51.3.221.1","unstructured":"WHO . Abortion Care Guideline. 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Abortlag (1974: 595). Stockholm, Sweden, 1974."},{"key":"2025090511104872000_51.3.221.9","unstructured":"Socialstyrelsen . Socialstyrelsens f\u00f6reskrifter om abort (2009:15). Stockholm, Sweden, 2009."},{"key":"2025090511104872000_51.3.221.10","unstructured":"Department of Health and Social Care . At home early medical abortions made permanent in England and Wales. 2022. Available: https:\/\/www.gov.uk\/government\/news\/at-home-early-medical-abortions-made-permanent-in-england-and-wales"},{"key":"2025090511104872000_51.3.221.11","doi-asserted-by":"crossref","unstructured":"Scottish Government . Early medical abortion at home. 2022. Available: https:\/\/www.gov.scot\/news\/early-medical-abortion-at-home-1\/","DOI":"10.1093\/med\/9780192896155.003.0001"},{"key":"2025090511104872000_51.3.221.12","unstructured":"Gemzell-Danielsson K , Brynhildsen J , Lindh I , et al . Evaluation of taking mifepristone at home during a medical abortion. PROSPERO. 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