Medication Abortion Provided Through Telemedicine in Four U.S. States

Kohn, Julia E.; Snow, Jennifer; Simons, Hannah R.; Seymour, J; Thompson, Terri-Ann; Grossman, Daniel

doi:10.1097/aog.0000000000003357

Cited by 48 publications

(54 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar developments may have contributed to the increase in clinics in Alaska and Washington. 20 The overall number of clinics in the Midwest and the South declined. Texas had the largest drop, losing seven clinic facilities between 2014 and 2017.…”

Section: Changes In Clinic Numbers Abortion Rates and Policy Contextmentioning

confidence: 99%

Abortion Incidence and Service Availability in the United States, 2017

Jones¹,

Witwer²,

Jerman³

2019

145

143

View full text Add to dashboard Cite

This study used new data from the Guttmacher Institute to examine trends in abortion incidence and rates between 2014 and 2017. In addition, we examined changes in the number of health care facilities that provide abortions. ■ ■ In 2017, an estimated 862,320 abortions were provided in clinical settings in the United States, representing a 7% decline since 2014 and the continuation of a long-term trend. ■ ■ The U.S. abortion rate dropped to 13.5 abortions per 1,000 women aged 15-44 in 2017, the lowest rate recorded since abortion was legalized in 1973. Abortion rates fell in most states and in all four regions of the country. ■ ■ A total of 339,640 medication abortions occurred in 2017-about 39% of all abortions. ■ ■ As in previous years, clinics provided the overwhelming majority of U.S. abortions (95%), while private physicians' offices and hospitals accounted for 5%. ■ ■ In 2017, 808 clinic facilities provided abortions, a 2% increase from 2014. However, regional and state disparities in clinic availability grew more pronounced; the number of clinics increased in the Northeast and the West, by 16% and 4% respectively, and decreased in the Midwest and the South, by 6% and 9%, respectively. ■ ■ Although the number of state abortion restrictions continued to increase in the Midwest and South between 2014 and 2017, these restrictive policies do not appear to have been the primary driver of declining abortion rates. There was also no consistent relationship between increases or decreases in clinic numbers and changes in state abortion rates. ■ ■ Fertility rates declined in almost all states between 2014 and 2017, and it is unlikely that the decline in abortion was due to an increase in unintended births. ■ ■ Factors that may have contributed to the decline in abortion were improvements in contraceptive use and increases in the number of individuals relying on self-managed abortions outside of a clinical setting.

show abstract

Section: Changes In Clinic Numbers Abortion Rates and Policy Contextmentioning

confidence: 99%

Abortion Incidence and Service Availability in the United States, 2017

Jones¹,

Witwer²,

Jerman³

2019

145

143

View full text Add to dashboard Cite

show abstract

“…Perceived usefulness is defined as the degree to which an individual believes that using a particular technology would be beneficial, and both OFCs and reproductive hormone SCTs may be perceived as useful. Indeed, telemedicine allows health care providers to offer the same services they provide to patients during in-person consultations, 18,19 and studies directly comparing phone-or video-based consultations to inperson health care consultations suggest similar patient outcomes and satisfaction. 22,23 Together, this suggests that online consultations may be as useful as traditional in-person health care consultations.…”

Section: Tam: Perceived Usefulness and Perceived Ease Of Usementioning

confidence: 99%

“…Perceived ease of use is defined as the degree to which an individual believes that using a particular technology would be free from effort, and both OFCs and reproductive hormone SCTs may also be perceived as easy to use. Indeed, past research has found that both online consultations 18,30 and SCTs 21 for a wide range of health services circumvent the geographic, financial, and time-based limitations of in-person health care services. 8,31 Both OFCs and reproductive hormone SCTs can also be used discreetly and in the privacy of one's own home, thus potentially mitigating some of the stigma felt by women pursuing fertility care.…”

Section: Tam: Perceived Usefulness and Perceived Ease Of Usementioning

confidence: 99%

“…17 New applications of health technologies have created an opportunity to overcome these barriers in accessing reproductive health care. Across sexual health care, there have been rapid increases in telemedicine 18,19 and self-collection tests (SCTs) 20,21 that have mitigated barriers to access, while still maintaining a high standard of patient treatment and satisfaction. 18,22,23 Within reproductive health care, it has recently become possible for women to seek care from fertility specialists through online fertility consultations (OFCs) and for women to use low-cost, reproductive hormone SCTs.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

US Women's Perceptions and Acceptance of New Reproductive Health Technologies

Worthington

Burke²,

Shirazi³

et al. 2020

Women's Health Reports

View full text Add to dashboard Cite

Background: Women have faced persistent problems accessing reproductive health care. New applications of health technologies to reproductive health, specifically online fertility specialist consultations and reproductive hormone self-collection tests (SCTs), present unique opportunities to overcome these issues. This article uses the technology acceptance model to examine factors that influence women's intentions to use these new reproductive health technologies. Materials and Methods: Participants (n = 327 US women) completed an online survey assessing perceptions related to both of these reproductive health technologies, including usefulness, ease of use, risk, trust, subjective norms, and personal responsibility, to learn about fertility. Results: Participants indicated high perceptions of usefulness, ease of use, and trust, as well as low perceptions of risk and subjective norms for both online fertility consultations (OFCs) and reproductive hormone SCTs. Women indicated low perceptions of responsibility to use OFCs, but high perceptions of responsibility to use reproductive hormone SCTs. Structural equation modeling indicated that intentions to use OFCs were predicted by usefulness, subjective norms, and responsibility; intentions to use reproductive hormone SCTs were predicted by usefulness, ease of use, subjective norms, and responsibility. Conclusions: Fertility specialist consultations and reproductive hormone testing can provide women with essential fertility information that facilitates informed reproductive decisions; however, these services have historically been difficult to access. Widespread uptake of new reproductive health technologies could promote positive advances in women's reproductive health outcomes.

show abstract

“…In rural communities, and to increase privacy for all, a clinic based telemedicine service could be set up, whereby medical consultation with a clinician takes place remotely and drugs are provided by a pharmacy or even by mail. Good evidence suggests that these services are safe, effective, and acceptable to patients 1415…”

Section: A Patient Centred Servicementioning

confidence: 99%