Evidence map›Paper›PMID 36736715›Full record

ArticleContraception2023

Mailing abortion pills does not delay care: A cohort study comparing mailed to in-person dispensing of abortion medications in the United States.

Leah R Koenig, Elizabeth G Raymond, Marji Gold, Christy M Boraas, Bliss Kaneshiro, Beverly Winikoff, Leah Coplon, Ushma D Upadhyay

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Contraception, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Leah R KoenigAdvancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, Oakland, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA; Center for Gender and Health Justice, University of California Global Health Institute.
Elizabeth G RaymondGynuity Health Projects, New York, NY, USA.
Marji GoldDepartment of Family and Social Medicine, Montefiore Medical Center, The Bronx, NY, USA.
Christy M BoraasPlanned Parenthood North Central States, Saint Paul, MN, USA.
Bliss KaneshiroDeparment of Obstetrics, Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
Beverly WinikoffGynuity Health Projects, New York, NY, USA.
Leah CoplonMaine Family Planning, Augusta, ME, USA.
Ushma D UpadhyayAdvancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, Oakland, CA, USA; Center for Gender and Health Justice, University of California Global Health Institute. Electronic address: ushma.upadhyay@ucsf.edu.

Funding

UCSF Data Science Training to Advance Behavioral and Social Science Expertise for Health Research (DaTABASE) ProgramT32MD015070 · NIMHD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI William Brown III, Yulin Hswen · 2020 to 2026
$1.7M
NIMHD NIH HHS T32 MD015070
6 · The paper itself

Abstract

objectiveGiven the substantial barriers to abortion access in the United States, many clinics now mail patients abortion medications. We examined whether dispensing the medications by mail prolonged time to medication use. STUDY

designWe analyzed data from no-test medication abortions with medication provided either by mail or in a clinic from 11 United States clinics from February 2020 to January 2021. We examined mean number of days from patients' first contact with the clinic to mifepristone ingestion, its two-component intervals (first contact to medication dispensing and dispensing to mifepristone ingestion), and pregnancy duration at mifepristone ingestion. We used Poisson regression to compare mean outcomes across three dispensing methods: in-person, mailed from the clinic, and mailed from a mail-order pharmacy.

resultsAmong the 2600 records, patients took mifepristone on average at 49 days of gestation (95% CI, 47-51) and 7 days (95% CI, 4-10) after first contact. Mean time from first contact to mifepristone ingestion was 6 days when medications were dispensed in-person and 9 days when mailed (p = 0.38). While time from first contact to dispensing was similar across methods (6 days in-person, 5 days mailed, p = 0.77), more time elapsed from dispensing to mifepristone ingestion when medications were mailed (4 days from clinic, 5 days from mail-order pharmacy) versus dispensed in-person (0.3 days, p < 0.001). Time to mifepristone ingestion was shorter with higher pregnancy duration. Pregnancy duration at ingestion was similar across methods (48 days in-person, 50 days mailed).

conclusionsMailing medications did not significantly prolong time from patients' first contact with the clinic to mifepristone ingestion or increase pregnancy duration at mifepristone ingestion. IMPLICATIONS: Abortion providers should offer a range of medication abortion dispensing options, prioritizing patient preference.

Indexed as

Abortion, InducedMisoprostolPharmaceutical ServicesPharmaciesCohort StudiesFemaleHumansMifepristonePregnancyUnited StatesMifepristoneMisoprostolMailingMedication abortionMifepristonePharmacyRisk Evaluation and Mitigation Strategy (REMS)Telehealth

Identifiers

PMID36736715
PMCPMC10759792

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.