Rebecca Araujo

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A study in JAMA found that medication abortion obtained using a no-test telehealth service was noninferior to in-person medication abortion in terms of safety and efficacy.
The researchers conducted a prospective, observational study of medication abortion outcomes in 4 sites across Colorado, Illinois, Maryland, Minnesota, Virginia, and Washington from May 2021 to May 2023. Eligible participants were aged 15 years and older and were seeking medication abortion up to and including 70 days’ gestation. English- and Spanish-speaking participants were enrolled. Three study groups were investigated: no-test (telehealth) eligibility assessment and mailing of medications, no-test assessment and pickup of medications, and in-person ultrasonography.
In total, 585 participants were enrolled. There were 228 participants in the no-test and mail group, 119 in the no-test and pickup group, and 238 in the in-person group. Most participants identified as non-Hispanic White (48.6%) or non-Hispanic Black (28.1%). Median gestational duration was 45 days and was comparable between those who received a telehealth or in-person medication abortion. Data regarding abortion outcomes were available from 91.8% of participants. Effectiveness was defined as a complete abortion without the need for repetition of the mifepristone and misoprostol regimen or a follow-up procedure.
The overall effectiveness of the no-test and mail regimen was 94.4% (95% CI, 90.7-99.2) compared with 93.3% in the in-person regimen (95% CI, 88.3-98.2), which met the prespecified 5.0% noninferiority margin for effectiveness. One percent of participants experienced a serious adverse event (95% CI, 0.4-2.4), including 3 in the no-test and mail group, 3 in the in-person with ultrasonography group, and none in the no-test and pickup group. In the entire population, there were 4 overnight hospitalizations, 2 blood transfusions, and 1 emergency surgery.
In summary, the authors wrote, “The findings suggest that models of medication abortion care that rely on no-test eligibility assessment and mailing medications to patients are an option for individuals considering medication abortion.”
Source: <a href="https://jamanetwork.com/journals/jama/article-abstract/2820321" target="_blank" rel="noopener">JAMA</a>

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Medication abortion obtained via mail after a no-test telehealth service was as effective as in-person medication abortion.

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