Medication Abortion Follow-Up Rates in a Rural Population Before and After Introduction of a Remote Follow-Up Option

Area of Science:

• Reproductive Health
• Telemedicine
• Public Health

Background:

• Traditional medication abortion (MAB) follow-up requires in-person visits for testing, posing challenges for rural patients.
• Long travel distances in rural states like New Mexico make dual-visit protocols burdensome.
• Prior studies indicate remote follow-up for MAB is feasible, safe, and preferred by patients.

Purpose of the Study:

• To evaluate if telephone-based MAB follow-up has noninferior loss-to-follow-up (LTFU) rates compared to traditional in-person follow-up in a rural population.
• To assess complication rates and protocol adherence in a remote MAB follow-up model.
• To compare the effectiveness of remote versus in-person follow-up for medication abortion.

Main Methods:

• Retrospective chart review of MAB patients at the University of New Mexico.
• Propensity-matched comparison of a telephone follow-up group (home group, n=136) with a historical in-person follow-up cohort (health care group, n=272).
• LTFU defined as no contact within 50 days; evaluation of complications, ongoing pregnancy, and protocol completion (calls, urine pregnancy test).

Main Results:

• LTFU rates were noninferior: 17% (home group) vs. 22% (health care group), p=0.24.
• Rates of complications requiring intervention and possible ongoing pregnancy were similar between groups (p>0.70).
• Protocol completion rates were high, with 70% of the home group following up by their intended method, comparable to the health care group (73%).

Conclusions:

• Telephone-based MAB follow-up is a viable alternative to in-person visits in rural settings.
• Remote follow-up demonstrates noninferior LTFU rates and comparable safety profiles.
• This model reduces patient burden without compromising care quality for medication abortion.