PDF(Pubmed)
Abstract：
BACKGROUND: This qualitative study aims to assess perspectives of clinicians and clinic staff on mail-order pharmacy dispensing for medication abortion.
METHODS: Participants included clinicians and staff involved in implementing a mail-order dispensing model for medication abortion at eleven clinics in seven states as part of a prospective cohort study, which began in January 2020 (before the FDA removed the in-person dispensing requirement for mifepristone). From June 2021 to July 2022, we invited participants at the participating clinics, including six primary care and five abortion clinics, to complete a semi-structured video interview about their experiences. We then conducted qualitative thematic analysis of interview data, summarizing themes related to perceived benefits and concerns about the mail-order model, perceived patient interest, and potential barriers to larger-scale implementation.
RESULTS: We conducted 24 interviews in total with clinicians (13 physicians and one nurse practitioner) and clinic staff (n = 10). Participants highlighted perceived benefits of the mail-order model, including its potential to expand abortion services into primary care, increase patient autonomy and privacy, and to normalize abortion services. They also highlighted key logistical, clinical, and feasibility concerns about the mail-order model, and specific challenges related to integrating abortion into primary care.
CONCLUSIONS: Clinicians and clinic staff working in primary care and abortion clinics were optimistic that mail-order dispensing of medication abortion can improve the ability of some providers to provide abortion and enable more patients to access services. The feasibility of mail-order pharmacy dispensing of medication abortion following the Supreme Court Dobbs decision is to be determined.
BACKGROUND: Registry: Clinicaltrials.gov.
BACKGROUND: NCT03913104. Date of registration: first submitted on April 3, 2019 and first posted on April 12, 2019.
METHODS: Participants included clinicians and staff involved in implementing a mail-order dispensing model for medication abortion at eleven clinics in seven states as part of a prospective cohort study, which began in January 2020 (before the FDA removed the in-person dispensing requirement for mifepristone). From June 2021 to July 2022, we invited participants at the participating clinics, including six primary care and five abortion clinics, to complete a semi-structured video interview about their experiences. We then conducted qualitative thematic analysis of interview data, summarizing themes related to perceived benefits and concerns about the mail-order model, perceived patient interest, and potential barriers to larger-scale implementation.
RESULTS: We conducted 24 interviews in total with clinicians (13 physicians and one nurse practitioner) and clinic staff (n = 10). Participants highlighted perceived benefits of the mail-order model, including its potential to expand abortion services into primary care, increase patient autonomy and privacy, and to normalize abortion services. They also highlighted key logistical, clinical, and feasibility concerns about the mail-order model, and specific challenges related to integrating abortion into primary care.
CONCLUSIONS: Clinicians and clinic staff working in primary care and abortion clinics were optimistic that mail-order dispensing of medication abortion can improve the ability of some providers to provide abortion and enable more patients to access services. The feasibility of mail-order pharmacy dispensing of medication abortion following the Supreme Court Dobbs decision is to be determined.
BACKGROUND: Registry: Clinicaltrials.gov.
BACKGROUND: NCT03913104. Date of registration: first submitted on April 3, 2019 and first posted on April 12, 2019.
摘要：
背景：这项定性研究旨在评估临床医生和临床工作人员对邮购药房分配药物流产的看法。
方法：作为前瞻性队列研究的一部分，参与者包括参与在7个州的11个诊所实施药物流产邮购配药模式的临床医生和工作人员。始于2020年1月（在FDA取消了米非司酮的当面配药要求之前）。从2021年6月到2022年7月，我们邀请了参与诊所的参与者，包括六个初级保健和五个堕胎诊所，完成关于他们经历的半结构化视频采访。然后，我们对访谈数据进行了定性主题分析，总结与感知到的好处和对邮购模式的关注相关的主题，感知到的患者兴趣，以及大规模实施的潜在障碍。
结果：我们总共对临床医生（13名医生和一名执业护士）和诊所工作人员（n=10）进行了24次访谈。与会者强调了邮购模式的感知好处，包括将堕胎服务扩展到初级保健的潜力，增加患者的自主权和隐私，并使堕胎服务正常化。他们还强调了关键的后勤，临床,以及对邮购模式的可行性担忧，以及将堕胎纳入初级保健的具体挑战。
结论：初级保健和流产诊所的临床医生和诊所工作人员乐观地认为，邮购药物流产分配可以提高一些提供者提供流产的能力，并使更多的患者获得服务。根据最高法院多布斯的裁决，邮购药房分配药物流产的可行性有待确定。
背景：注册表：Clinicaltrials.gov.
背景：NCT03913104。注册日期：2019年4月3日首次提交，2019年4月12日首次发布。
方法：作为前瞻性队列研究的一部分，参与者包括参与在7个州的11个诊所实施药物流产邮购配药模式的临床医生和工作人员。始于2020年1月（在FDA取消了米非司酮的当面配药要求之前）。从2021年6月到2022年7月，我们邀请了参与诊所的参与者，包括六个初级保健和五个堕胎诊所，完成关于他们经历的半结构化视频采访。然后，我们对访谈数据进行了定性主题分析，总结与感知到的好处和对邮购模式的关注相关的主题，感知到的患者兴趣，以及大规模实施的潜在障碍。
结果：我们总共对临床医生（13名医生和一名执业护士）和诊所工作人员（n=10）进行了24次访谈。与会者强调了邮购模式的感知好处，包括将堕胎服务扩展到初级保健的潜力，增加患者的自主权和隐私，并使堕胎服务正常化。他们还强调了关键的后勤，临床,以及对邮购模式的可行性担忧，以及将堕胎纳入初级保健的具体挑战。
结论：初级保健和流产诊所的临床医生和诊所工作人员乐观地认为，邮购药物流产分配可以提高一些提供者提供流产的能力，并使更多的患者获得服务。根据最高法院多布斯的裁决，邮购药房分配药物流产的可行性有待确定。
背景：注册表：Clinicaltrials.gov.
背景：NCT03913104。注册日期：2019年4月3日首次提交，2019年4月12日首次发布。
