Effectiveness and safety of medication abortion via telemedicine versus in-person: A cohort of pregnant people in Colombia
To compare the effectiveness and safety of medication abortion (MAB) via telemedicine versus in-person in pregnant people with less than 12 gestational weeks in Colombia. A retrospective cohort study was conducted with 23,362 pregnant people who requested MAB service from Profamilia (a Colombian non...
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| Veröffentlicht in: | Contraception (Stoneham) 2024-10, Vol.138, p.110514, Article 110514 |
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| creator | Cely-Andrade, Leonardo Cárdenas-Garzón, Karen Enríquez-Santander, Luis C. Saavedra-Avendano, Biani Ortiz-Avendano, Guillermo A. Betancourt-Rojas, Lucy A. Guerrero-Conde, Jorge G. |
| description | To compare the effectiveness and safety of medication abortion (MAB) via telemedicine versus in-person in pregnant people with less than 12 gestational weeks in Colombia.
A retrospective cohort study was conducted with 23,362 pregnant people who requested MAB service from Profamilia (a Colombian non-governmental organization) in 2021–2022. The outcomes were success and safety of MAB. We performed a descriptive and a multivariate statistical analysis using the binary regression model to obtain an adjusted Odds Ratio (aOR) to identify factors associated with abortion success.
In comparison to in-person care (n = 20,289), individuals in telemedicine (n = 3073) were predominantly from urban areas, belonged to a lower socioeconomic stratum, single and did not identify with any ethnic group. In-person users tended to have higher levels of education and accessed the service through private insurance (p |
| doi_str_mv | 10.1016/j.contraception.2024.110514 |
| format | Article |
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A retrospective cohort study was conducted with 23,362 pregnant people who requested MAB service from Profamilia (a Colombian non-governmental organization) in 2021–2022. The outcomes were success and safety of MAB. We performed a descriptive and a multivariate statistical analysis using the binary regression model to obtain an adjusted Odds Ratio (aOR) to identify factors associated with abortion success.
In comparison to in-person care (n = 20,289), individuals in telemedicine (n = 3073) were predominantly from urban areas, belonged to a lower socioeconomic stratum, single and did not identify with any ethnic group. In-person users tended to have higher levels of education and accessed the service through private insurance (p < 0,05). There were no differences in the odd of a successful abortion based on the modality of care (aOR 1.18; 95% CI=0.87–1.59). The results were also the same with sensitivity analysis stratified: pregnant people who were nine weeks gestation or less (aOR 0.86; 95% CI=0.63–1.17) or more (aOR 0.87; 95% CI=0.28–2.65).
Telemedicine is an effective and safe option for MAB, as in-person care. Telemedicine has the potential to increase abortion access by extending the availability of providers and offering people a new option for obtaining care conveniently and privately, especially for women with disadvantaged socioeconomic and educational background.
This study demonstrates that medication abortion (MAB) administered via telemedicine produces outcomes akin to those of in-person care, providing a compelling rationale for its adoption, particularly in underserved regions. This approach can be replicated in other countries in Latin America and the Caribbean.</description><identifier>ISSN: 0010-7824</identifier><identifier>ISSN: 1879-0518</identifier><identifier>EISSN: 1879-0518</identifier><identifier>DOI: 10.1016/j.contraception.2024.110514</identifier><identifier>PMID: 38879070</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abortifacient Agents - administration & dosage ; Abortion, Induced - methods ; Adolescent ; Adult ; Colombia ; Effectiveness ; Female ; Humans ; In-person care ; Medication abortion ; Pregnancy ; Retrospective Studies ; Safety ; Telemedicine ; Young Adult</subject><ispartof>Contraception (Stoneham), 2024-10, Vol.138, p.110514, Article 110514</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c255t-327b8ff050f4f67b29699c69d09eca9e48ec6c4cf093997e6fa2b35636d3de5f3</cites><orcidid>0000-0002-1221-911X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.contraception.2024.110514$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38879070$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cely-Andrade, Leonardo</creatorcontrib><creatorcontrib>Cárdenas-Garzón, Karen</creatorcontrib><creatorcontrib>Enríquez-Santander, Luis C.</creatorcontrib><creatorcontrib>Saavedra-Avendano, Biani</creatorcontrib><creatorcontrib>Ortiz-Avendano, Guillermo A.</creatorcontrib><creatorcontrib>Betancourt-Rojas, Lucy A.</creatorcontrib><creatorcontrib>Guerrero-Conde, Jorge G.</creatorcontrib><title>Effectiveness and safety of medication abortion via telemedicine versus in-person: A cohort of pregnant people in Colombia</title><title>Contraception (Stoneham)</title><addtitle>Contraception</addtitle><description>To compare the effectiveness and safety of medication abortion (MAB) via telemedicine versus in-person in pregnant people with less than 12 gestational weeks in Colombia.
A retrospective cohort study was conducted with 23,362 pregnant people who requested MAB service from Profamilia (a Colombian non-governmental organization) in 2021–2022. The outcomes were success and safety of MAB. We performed a descriptive and a multivariate statistical analysis using the binary regression model to obtain an adjusted Odds Ratio (aOR) to identify factors associated with abortion success.
In comparison to in-person care (n = 20,289), individuals in telemedicine (n = 3073) were predominantly from urban areas, belonged to a lower socioeconomic stratum, single and did not identify with any ethnic group. In-person users tended to have higher levels of education and accessed the service through private insurance (p < 0,05). There were no differences in the odd of a successful abortion based on the modality of care (aOR 1.18; 95% CI=0.87–1.59). The results were also the same with sensitivity analysis stratified: pregnant people who were nine weeks gestation or less (aOR 0.86; 95% CI=0.63–1.17) or more (aOR 0.87; 95% CI=0.28–2.65).
Telemedicine is an effective and safe option for MAB, as in-person care. Telemedicine has the potential to increase abortion access by extending the availability of providers and offering people a new option for obtaining care conveniently and privately, especially for women with disadvantaged socioeconomic and educational background.
This study demonstrates that medication abortion (MAB) administered via telemedicine produces outcomes akin to those of in-person care, providing a compelling rationale for its adoption, particularly in underserved regions. This approach can be replicated in other countries in Latin America and the Caribbean.</description><subject>Abortifacient Agents - administration & dosage</subject><subject>Abortion, Induced - methods</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Colombia</subject><subject>Effectiveness</subject><subject>Female</subject><subject>Humans</subject><subject>In-person care</subject><subject>Medication abortion</subject><subject>Pregnancy</subject><subject>Retrospective Studies</subject><subject>Safety</subject><subject>Telemedicine</subject><subject>Young Adult</subject><issn>0010-7824</issn><issn>1879-0518</issn><issn>1879-0518</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1qGzEUhUVIaNy0r1AE3XQzztX86CddBeM2gUA26VpoNFepzFiaSGND8vSV47TQXVY6oO_egz4R8pXBkgHjl5uljWFOxuI0-xiWNdTtkjHoWHtCFkwKVZUsT8kCgEElZN2ek485bwBAqE58IOeNLBQIWJCXtXNoZ7_HgDlTEwaajcP5mUZHtzh4aw4l1PQxvYa9N3TGEV_vfEC6x5R3mfpQTSXFcEWvqY2_C35YMSV8DCbMdMI4jVgwuopj3PbefCJnzowZP7-dF-TXj_XD6qa6u_95u7q-q2zddXPV1KKXzkEHrnVc9LXiSlmuBlBojcJWouW2tQ5Uo5RA7kzdNx1v-NAM2Lnmgnw77p1SfNphnvXWZ4vjaALGXdYNcCk62cq6oN-PqE0x54ROT8lvTXrWDPRBvt7o_-Trg3x9lF-mv7wV7fqi59_sX9sFWB8BLM_de0w6W4_BFpWpfIIeon9X0R_bCaAQ</recordid><startdate>202410</startdate><enddate>202410</enddate><creator>Cely-Andrade, Leonardo</creator><creator>Cárdenas-Garzón, Karen</creator><creator>Enríquez-Santander, Luis C.</creator><creator>Saavedra-Avendano, Biani</creator><creator>Ortiz-Avendano, Guillermo A.</creator><creator>Betancourt-Rojas, Lucy A.</creator><creator>Guerrero-Conde, Jorge G.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1221-911X</orcidid></search><sort><creationdate>202410</creationdate><title>Effectiveness and safety of medication abortion via telemedicine versus in-person: A cohort of pregnant people in Colombia</title><author>Cely-Andrade, Leonardo ; Cárdenas-Garzón, Karen ; Enríquez-Santander, Luis C. ; Saavedra-Avendano, Biani ; Ortiz-Avendano, Guillermo A. ; Betancourt-Rojas, Lucy A. ; Guerrero-Conde, Jorge G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c255t-327b8ff050f4f67b29699c69d09eca9e48ec6c4cf093997e6fa2b35636d3de5f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abortifacient Agents - administration & dosage</topic><topic>Abortion, Induced - methods</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Colombia</topic><topic>Effectiveness</topic><topic>Female</topic><topic>Humans</topic><topic>In-person care</topic><topic>Medication abortion</topic><topic>Pregnancy</topic><topic>Retrospective Studies</topic><topic>Safety</topic><topic>Telemedicine</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cely-Andrade, Leonardo</creatorcontrib><creatorcontrib>Cárdenas-Garzón, Karen</creatorcontrib><creatorcontrib>Enríquez-Santander, Luis C.</creatorcontrib><creatorcontrib>Saavedra-Avendano, Biani</creatorcontrib><creatorcontrib>Ortiz-Avendano, Guillermo A.</creatorcontrib><creatorcontrib>Betancourt-Rojas, Lucy A.</creatorcontrib><creatorcontrib>Guerrero-Conde, Jorge G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Contraception (Stoneham)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cely-Andrade, Leonardo</au><au>Cárdenas-Garzón, Karen</au><au>Enríquez-Santander, Luis C.</au><au>Saavedra-Avendano, Biani</au><au>Ortiz-Avendano, Guillermo A.</au><au>Betancourt-Rojas, Lucy A.</au><au>Guerrero-Conde, Jorge G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness and safety of medication abortion via telemedicine versus in-person: A cohort of pregnant people in Colombia</atitle><jtitle>Contraception (Stoneham)</jtitle><addtitle>Contraception</addtitle><date>2024-10</date><risdate>2024</risdate><volume>138</volume><spage>110514</spage><pages>110514-</pages><artnum>110514</artnum><issn>0010-7824</issn><issn>1879-0518</issn><eissn>1879-0518</eissn><abstract>To compare the effectiveness and safety of medication abortion (MAB) via telemedicine versus in-person in pregnant people with less than 12 gestational weeks in Colombia.
A retrospective cohort study was conducted with 23,362 pregnant people who requested MAB service from Profamilia (a Colombian non-governmental organization) in 2021–2022. The outcomes were success and safety of MAB. We performed a descriptive and a multivariate statistical analysis using the binary regression model to obtain an adjusted Odds Ratio (aOR) to identify factors associated with abortion success.
In comparison to in-person care (n = 20,289), individuals in telemedicine (n = 3073) were predominantly from urban areas, belonged to a lower socioeconomic stratum, single and did not identify with any ethnic group. In-person users tended to have higher levels of education and accessed the service through private insurance (p < 0,05). There were no differences in the odd of a successful abortion based on the modality of care (aOR 1.18; 95% CI=0.87–1.59). The results were also the same with sensitivity analysis stratified: pregnant people who were nine weeks gestation or less (aOR 0.86; 95% CI=0.63–1.17) or more (aOR 0.87; 95% CI=0.28–2.65).
Telemedicine is an effective and safe option for MAB, as in-person care. Telemedicine has the potential to increase abortion access by extending the availability of providers and offering people a new option for obtaining care conveniently and privately, especially for women with disadvantaged socioeconomic and educational background.
This study demonstrates that medication abortion (MAB) administered via telemedicine produces outcomes akin to those of in-person care, providing a compelling rationale for its adoption, particularly in underserved regions. This approach can be replicated in other countries in Latin America and the Caribbean.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38879070</pmid><doi>10.1016/j.contraception.2024.110514</doi><orcidid>https://orcid.org/0000-0002-1221-911X</orcidid></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Abortifacient Agents - administration & dosage Abortion, Induced - methods Adolescent Adult Colombia Effectiveness Female Humans In-person care Medication abortion Pregnancy Retrospective Studies Safety Telemedicine Young Adult |
| title | Effectiveness and safety of medication abortion via telemedicine versus in-person: A cohort of pregnant people in Colombia |
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