Telemedicine early medical abortion at home: evaluation

Aims

The aims of this evaluation as detailed in the Scottish Government-commissioned invitation to tender were:

• To determine whether the delivery of EMAH in Scotland without any in-person appointment is a safe and effective means of providing abortion treatment, both in terms of evidence of clinical risk and of patient experience.
• To evaluate the comparative effectiveness of the differing approaches used by NHS Boards since March 2020 to deliver early medical abortion at home (in terms of patient safety, patient experience and wider sexual health service provision for patients having abortions).

The key research questions to be considered by the evaluation to answer the above were:

1. What are the clinical benefits and risks of delivery of early medical abortion at home in Scotland without an in-person appointment?

2. What are the advantages and disadvantages for patients of the current approach to early medical abortion at home versus the pre-March 2020 approach?

3. To what extent have different groups of patients been impacted in different ways by the delivery of early medical abortion at home in Scotland without an in-person appointment, how and why?

4. In comparison with the pre-March 2020 approach, how effective are the different approaches adopted to delivery of early medical abortion at home in different NHS Health Boards in terms of:

• Patient safety
• Patient experience
• Access to and uptake of wider sexual health service provision

What are the advantages and disadvantages of each differing approach?