Telemedicine early medical abortion at home: evaluation

Conclusion

The findings of this evaluation support the effectiveness, and acceptability of the current models of EMAH in Scotland and the work packages all indicate that the benefits of the current model outweigh any risks. The move to not routinely using ultrasound was associated with a small number of adverse outcomes (later than expected stage of pregnancy or delayed diagnosis of pregnancy of unknown location/ectopic) out of thousands of EMAHs conducted, and not all would have been averted even if ultrasound had been conducted before treatment in every case. The findings of the patient survey show that patients value choice and options around their EMAH care. Patients value the option to have a telephone or in-person consultation, to have or not to have an ultrasound (unless clinically required), to have options on where they can access abortion medications and the option to be able to administer these at home. The findings from WP2 on variations in models of care across Scotland, along with feedback from the staff interviews, also lend support for optimising pathways by sharing patient information resources and protocols nationally and closer joint working by providers across Health Boards with more opportunities for collaborative research and peer support.