Characteristics of patients having telemedicine versus in-person informed consent visits before abortion in Utah

Characteristics of patients having telemedicine versus in-person informed consent visits before abortion in Utah
Sara Daniel, Sarah Raifman, Shelly Kaller, Daniel Grossman
Contraception, 4 September 2019
Abstract
Objective
This study aimed to evaluate demographic and service delivery differences between patients using telemedicine relative to an in-person visit to satisfy Utah’s state-mandated informed consent visit, which must occur at least 72 h before the abortion.
Study design
We conducted a retrospective cohort study with data from Planned Parenthood Association of Utah (PPAU), which included all informed consent and abortion encounters from January 1, 2015 – March 31, 2018. We evaluated the following for each encounter by informed consent type (telemedicine vs. in-person): demographics, distance to a PPAU facility, length of time between informed consent and abortion visits, and gestational age at time of abortion.
Results
Of the 9175 informed consent visits, 91% were in-person (n=8395) and 9% were via telemedicine (n=780), which ranged from 5% in 2015 to 16% in 2018. Compared to in-person patients, telemedicine patients were slightly older (27 vs. 25 median years, p<.001), more likely to live out of state (47% vs. 4%, p<.001) and further away from PPAU clinics offering informed consent visits (104 miles vs. 10 median miles, p<.001). Among those who received abortion care at PPAU (6233), telemedicine informed consent patients were more likely to have medication abortions (adjusted odds ratio 1.68, 95% confidence interval 1.28–2.19) compared to in-person informed consent patients.
Conclusions
PPAU’s telemedicine option for completing the abortion informed consent visit appears to be of particular interest to patients who live further from clinics, including out of state, as it could help reduce travel burdens imposed by Utah’s mandatory delay law.
Implications
Telemedicine provision of state-mandated informed consent is feasible and could be used in other states where similar mandatory delays before abortion are required and where telemedicine is allowed.

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