Client satisfaction and experience of home use of mifepristone and
misoprostol for medical abortion up to 10 weeks’ gestation at British
Pregnancy Advisory Service: a cross-sectional evaluation
Abstract
Objective: Evaluate satisfaction and experience with telemedicine and
home use of mifepristone and misoprostol for abortion to 10 weeks’
gestation. Design: Cross-sectional evaluation. Setting: British
Pregnancy Advisory Service (BPAS) clinics in England and Wales.
Population: 1,144 clients who used mifepristone and misoprostol at home
from 11 May to 10 July 2020. Methods: We sent a text message with a link
to a web-survey 2-3 weeks after treatment. Questions evaluated
satisfaction and experiences, including telephone consultations and
provision of medicines by post or collection from clinic. We used
bivariate and multivariate regression to explore associations between
client characteristics and outcomes. Main Outcome Measures: Overall
satisfaction (5-point Likert scale) and reported contact with a
healthcare provider (HCP). Results: Respondents primarily described home
use of medications as ‘straightforward’ (75.8%) and most were ‘very
satisfied’ (78.3%) or ‘satisfied’ (18.6%) with their overall
experience. Being ‘very satisfied’ was associated with parity (aOR 1.53,
95% CI 1.09-2.14) and pain control satisfaction (aOR 2.22, 95% CI
1.44-3.44). HCP contact was reported by 14.7%; mainly to BPAS’
telephone aftercare service (76.8%). Dissatisfaction with pain control
(aOR 3.62 95% CI 1.79-7.29) and waiting >1 week to use
mifepristone (aOR3.71, 95% CI 1.48-9.28) were associated with HCP
contact. If needed in future, most (77.8%) would prefer home use of
mifepristone and misoprostol and pills by post (68.9%). Conclusions:
Satisfaction with home use of mifepristone and misoprostol is high. Most
clients do not need HCP support during or after home use, but aftercare
should be available.