ArticleBMJ sexual & reproductive health2023
A prospective, comparative study of clinical outcomes following clinic-based versus self-use of medical abortion.
Article in BMJ sexual & reproductive health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Self-managed medical abortion in Nigeria: a prospective, comparative study of clinical outcomes for a misoprostol-alone regimen obtained from patent medicine vendors compared to clinics.Reproductive health · 2026Article
- Non-facility MMA (Medical Methods of Abortion) use for induced abortion: A study of women with access to safe abortion services in Lucknow.Journal of family medicine and primary care · 2026Article
- Who pays more? Exploring cost disparities in medication abortion access across socio-demographic groups in Ghana.International journal for equity in health · 2025Article
- Quality of care offered by health care retail markets for medication abortion self-management: Findings from states in Nigeria and India.PLOS global public health · 2025Article
- Increasing access to self-managed abortion through pharmacies: programmatic results and lessons from a pilot program in Oromia, Ethiopia.Frontiers in reproductive health · 2025Article
- Developing and validating an abortion care quality metric for facility and out-of-facility settings: an observational cohort study in Bangladesh, Ethiopia, and Nigeria.EClinicalMedicine · 2023Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo determine whether clinical outcomes differ among women accessing a combined medical abortion regimen from a health clinic when compared with those accessing it from a pharmacy.
methodsWe conducted a multicentre, prospective, comparative, non-inferiority study of participants aged ≥15 years seeking medical abortion from five clinics and five adjacent pharmacy clusters in three provinces of Cambodia. Participants were recruited in-person at the point of purchase (clinic or pharmacy). Follow-up for self-reported pill use, acceptability, and clinical outcomes occurred by telephone at days 10 and 30 after mifepristone administration.
resultsOver 10 months, we enrolled 2083 women with 1847 providing outcome data: 937 from clinics and 910 from pharmacies. Most were early in their pregnancy (mean gestational age of 6.3 and 6.1 weeks, respectively) and almost all took the pills correctly (98% and 96%,). Additional treatment needed to complete the abortion was non-inferior for the pharmacy group (9.3%) compared with the clinic group (12.7%). More from the clinic group received additional care from a provider, such as antibiotics or diagnostics tests, than those from the pharmacy group (11.5% and 3.2%,), and one ectopic pregnancy (pharmacy group) was successfully treated. Most said they felt prepared for what happened after taking the pills (90.9% and 81.3%, respectively, p=0.273).
conclusionsSelf-use of a combined medical abortion product resulted in comparable clinical outcomes as use following a clinical visit, consistent with existing literature on its safety and efficacy. Registration and availability of medical abortion as an over-the-counter product would likely increase women's access to safe abortion.
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