Abstract：
OBJECTIVE: To evaluate safety, feasibility, and acceptability of a telemedicine medical abortion service without pre-treatment in-person tests in Ukraine, Uzbekistan, and Azerbaijan.
METHODS: We conducted an open-label, prospective, observational clinical study at five clinics in the three countries. Interested and eligible participants scheduled a telemedicine consultation with a study provider by phone or video. Medical abortion pills could be obtained by mail or courier or picked up at the study clinic or a pharmacy. Study providers contacted participants 1 week after mifepristone ingestion to assess abortion outcomes based on symptoms, and 3 weeks later to review the result of an at-home, high-sensitivity, urine pregnancy test. Participants were referred to in-person visit based on symptoms, urine pregnancy test results, or initiative by the participant.
RESULTS: In all, 300 women participated in the study. Almost all participants received medical abortion medications the same day as their first contact with the study clinic, and the majority (n = 297, 99.0%) did not experience any problems receiving them. All except two women (0.67%) followed provider instructions on administration of medications. The majority of participants had a complete abortion without a procedure (Ukraine: n = 115, 95.8%; Uzbekistan: n = 127, 97.7%; Azerbaijan: n = 49, 98.0%), few had in-person visits (Ukraine: n = 30, 25.0%; Uzbekistan: n = 3, 2.3%; Azerbaijan: n = 4, 8.0%), and most were very satisfied or satisfied with the service (Ukraine: n = 116, 96%; Uzbekistan: n = 128, 98%; Azerbaijan: n = 45, 90%). No serious adverse events occurred.
CONCLUSIONS: Telemedicine medical abortion using the no-test protocol is safe, feasible and acceptable for women in Ukraine, Uzbekistan, and Azerbaijan.
METHODS: We conducted an open-label, prospective, observational clinical study at five clinics in the three countries. Interested and eligible participants scheduled a telemedicine consultation with a study provider by phone or video. Medical abortion pills could be obtained by mail or courier or picked up at the study clinic or a pharmacy. Study providers contacted participants 1 week after mifepristone ingestion to assess abortion outcomes based on symptoms, and 3 weeks later to review the result of an at-home, high-sensitivity, urine pregnancy test. Participants were referred to in-person visit based on symptoms, urine pregnancy test results, or initiative by the participant.
RESULTS: In all, 300 women participated in the study. Almost all participants received medical abortion medications the same day as their first contact with the study clinic, and the majority (n = 297, 99.0%) did not experience any problems receiving them. All except two women (0.67%) followed provider instructions on administration of medications. The majority of participants had a complete abortion without a procedure (Ukraine: n = 115, 95.8%; Uzbekistan: n = 127, 97.7%; Azerbaijan: n = 49, 98.0%), few had in-person visits (Ukraine: n = 30, 25.0%; Uzbekistan: n = 3, 2.3%; Azerbaijan: n = 4, 8.0%), and most were very satisfied or satisfied with the service (Ukraine: n = 116, 96%; Uzbekistan: n = 128, 98%; Azerbaijan: n = 45, 90%). No serious adverse events occurred.
CONCLUSIONS: Telemedicine medical abortion using the no-test protocol is safe, feasible and acceptable for women in Ukraine, Uzbekistan, and Azerbaijan.
摘要：
目的：为了评估安全性，可行性,以及在乌克兰不进行治疗前面对面测试的远程医疗堕胎服务的可接受性，乌兹别克斯坦,阿塞拜疆。
方法：我们进行了开放标签，prospective,在三个国家的五个诊所进行的观察性临床研究。有兴趣和符合条件的参与者通过电话或视频与研究提供者进行了远程医疗咨询。药物流产药可以通过邮寄或快递获得，也可以在研究诊所或药房领取。研究提供者在服用米非司酮1周后联系参与者，根据症状评估流产结果，3周后审查结果在家，高灵敏度,尿妊娠试验.参与者根据症状进行了当面访问，尿妊娠试验结果,或参与者的倡议。
结果：总而言之，300名妇女参加了这项研究。几乎所有参与者在第一次与研究诊所接触的同一天接受了药物流产药物，大多数（n=297，99.0％）在接收它们时没有遇到任何问题。除两名妇女（0.67％）外，所有妇女都遵循提供者的用药说明。大多数参与者在没有手术的情况下进行了完全流产（乌克兰：n=115，95.8％；乌兹别克斯坦：n=127，97.7％；阿塞拜疆：n=49，98.0％），很少有人亲自访问（乌克兰：n=30，25.0%；乌兹别克斯坦：n=3，2.3%；阿塞拜疆：n=4，8.0%），大多数人对服务非常满意或满意（乌克兰：n=116，96％；乌兹别克斯坦：n=128，98％；阿塞拜疆：n=45，90％）。无严重不良事件发生。
结论：使用无测试方案的远程医疗药物流产是安全的，乌克兰妇女是可行和可接受的，乌兹别克斯坦,阿塞拜疆。
方法：我们进行了开放标签，prospective,在三个国家的五个诊所进行的观察性临床研究。有兴趣和符合条件的参与者通过电话或视频与研究提供者进行了远程医疗咨询。药物流产药可以通过邮寄或快递获得，也可以在研究诊所或药房领取。研究提供者在服用米非司酮1周后联系参与者，根据症状评估流产结果，3周后审查结果在家，高灵敏度,尿妊娠试验.参与者根据症状进行了当面访问，尿妊娠试验结果,或参与者的倡议。
结果：总而言之，300名妇女参加了这项研究。几乎所有参与者在第一次与研究诊所接触的同一天接受了药物流产药物，大多数（n=297，99.0％）在接收它们时没有遇到任何问题。除两名妇女（0.67％）外，所有妇女都遵循提供者的用药说明。大多数参与者在没有手术的情况下进行了完全流产（乌克兰：n=115，95.8％；乌兹别克斯坦：n=127，97.7％；阿塞拜疆：n=49，98.0％），很少有人亲自访问（乌克兰：n=30，25.0%；乌兹别克斯坦：n=3，2.3%；阿塞拜疆：n=4，8.0%），大多数人对服务非常满意或满意（乌克兰：n=116，96％；乌兹别克斯坦：n=128，98％；阿塞拜疆：n=45，90％）。无严重不良事件发生。
结论：使用无测试方案的远程医疗药物流产是安全的，乌克兰妇女是可行和可接受的，乌兹别克斯坦,阿塞拜疆。
