In the Republic of Georgia, the medical abortion regimen involves three in-person visits. This study aims to pilot and evaluate a simplified medical abortion service delivery model that will reduce the number of in-person visits to only one visit for diagnosis and counseling. Medication will be mailed along with two multi-level pregnancy tests to study participants, who will assess their abortion outcome at home.
This prospective cohort study of patients obtaining medical abortion medications by mail. The study investigators aim to recruit approximately 120 patients for this study across three study sites that have extensive experience providing early medical abortion. Five days after undergoing in-person consultation and necessary exams to assess eligibility for medical abortion, study team will mail study participants medical abortion pills and two multi-level urine pregnancy tests. Medical abortion follow-up will occur at the participant's home approximately two weeks after the initial visit, and the multi-level pregnancy test will be used to assess abortion outcome. At follow-up, study participants will be asked questions about the results of the multi-level pregnancy test, and their experience and feedback about the acceptability of the process. At the conclusion of the study, investigators will interview providers to better undertand their experience with the simplified medical abortion service delivery model.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
120
Participants will receive mifepristone at a preferred address by mail rather than standard care at clinic visit.
Batumi Medical Center
Batumi, Georgia
RECRUITINGDavid Gagua Clinic
Tbilisi, Georgia
RECRUITINGClinic Elite
Zestaponi, Georgia
RECRUITINGNumber of participants who report satisfactory experience
Number of participants who report being "satisfied" or "very satisfied" with the simplified medical abortion service delivery model
Time frame: Day 14 following initial medical abortion visit
Number of providers who report satisfactory experience
Number of providers who report being "satisfied" or "very satisfied" with the simplified medical abortion service delivery model
Time frame: End of the study, month 15
Number of participants with adverse event
Number of participants who had a medical problem that required them to go to the hospital, emergency department or a doctor's office (other than regularly scheduled follow-up visit) since receiving medical abortion pills
Time frame: Up to 6 weeks after initial medical abortion visit
Number of participants with a complete abortion with medication alone and who do not require additional interventions to complete the procedure
Number of participants who report that their abortion is complete as assessed by the multi-level pregnancy test and medical history.
Time frame: Up to 6 weeks after initial medical abortion visit
Number of particpants with adverse event associated with mailing of medical abortion medications
Number of participants who had a problem (such as delayed and lost packages) receiving medical abortion medications by mail
Time frame: Up to 6 weeks after initial medical abortion visit
Cost associated with the simplified medical abortion service delivery model
Cost savings associated with participant travel to the clinic and cost of the standard care at the clinic.
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Time frame: Up to 6 weeks after initial medical abortion visit
Number of participants who refuse to receive medical abortion pills by mail
Number of participants who refuse to receive medical abortion pills by mail during the study period
Time frame: End of the study, month 15