New UW study on effective dispensing of abortion medications via telehealth services

Photo of Mifepristone, the abortion pill known as RU 486. (Photo by James Leynse/Corbis via Getty Images)

A study from the University of Washington on clinics' and primary care doctors' means of dispensing abortion medications during the pandemic may offer guidance for clinicians in a post-Roe v. Wade world.

The study, published Monday in the Annals of Family Medicine, examined services provided by family medicine clinicians in a variety of settings: family planning clinics, online medical services and primary care practices. 

Most abortion pills — a combination of two medications, mifepristone and misoprostol — are currently dispensed by independent reproductive health clinics, according to the study's senior author Dr. Emily Godfrey, an OB-GYN and family medicine physician at UW Medicine in Seattle.

With increasing restrictions on access to abortion care, the study provides "a roadmap for primary care and OB-GYN clinicians to rapidly initiate telemedicine abortion for patients, where the law allows," Godfrey said. 

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The researchers found similar procedures for remote medication abortion services across all healthcare settings, according to lead author Anna Fiastro, research manager of the University of Washington School of Medicine Family Planning division. Each site followed five basic steps for providing care: patient engagement, care consultations, payment, medication dispensing and follow-up communication.

The asynchronous method of patient-provider communication (email, text or electronic medical portal) usually took only two to three minutes of the clinician’s time, the study reported, in contrast to video calls that took an average of 10 to 30 minutes. Regardless of the setting, the medications were all delivered to the patient by mail. 

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The research was completed before the June decision by the Supreme Court that removed the constitutional right to abortion. The team interviewed a total of 21 doctors and staff in various states, including Washington, from November to December 2020. 

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Results from the study were used in creating the Access, Delivered Provider Toolkit, a step-by-step guide for providers interested in starting their own telemedicine abortion services. This is one of several studies on medicated abortion led by Godfrey, including two last year that evaluated demand and aftercare for patients. 

In December, the FDA lifted longstanding restrictions on mifepristone, allowing doctors to prescribe the medication after a telehealth visit and send them to patients by mail or via mail-order pharmacy. Abortion medications now account for over half of abortions in the United States.