Medication Abortion Via Pharmacy Dispensing

NCT ID: NCT03320057

Last Updated: 2021-07-12

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

326 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-06-01

Study Completion Date

2020-07-04

Brief Summary

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This mixed-methods study follows a prospective cohort of patients receiving Mifeprex ® (mifepristone) for medication abortion dispensed by pharmacists after undergoing standard clinical evaluation. Women participating in this study will obtain mifepristone and misoprostol from the pharmacy instead of in the clinic. To assess feasibility, acceptability, and effectiveness of pharmacy dispensing of mifepristone, the study will survey patients, evaluate their clinical outcomes from electronic health records, and survey and interview pharmacists at study sites.

Detailed Description

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Improving access to and efficiency of abortion provision is important for patients and providers. The Risk Evaluation and Mitigation Strategy (REMS) requires that Mifeprex ® ( mifepristone) be dispensed only from a doctor's office, clinic or hospital (not from a pharmacy by prescription) by a certified health care provider and the health care provider must obtained a signed Patient Agreement Form before dispensing mifepristone. Data are needed to investigate the feasibility, acceptability, and effectiveness of pharmacy dispensing of mifepristone. In order to address the study question, a mixed methods study design is appropriate. To assess feasibility, the study will collect data on pharmacists' satisfaction with dispensing mifepristone. To assess acceptability, qualitative data will be collected from pharmacists about their perspectives on dispensing Mifeprex before and after the study, as well as measure patient satisfaction through open-ended and close-ended survey questions. To assess effectiveness of the pharmacy dispensing model, the study will evaluate clinical outcomes from electronic health records. The proposed feasibility study would take place at sites in California and Washington states.

Conditions

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Pregnancy Related Abortion Early

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Prospective cohort
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Medication abortion patients

Oral mifepristone 200 mg, followed by misoprostol 800 mcg administered buccally (at 24-48 hours following mifepristone) or vaginally (as soon as 6 hours following mifepristone)

Group Type EXPERIMENTAL

Mifepristone

Intervention Type DRUG

Patients will receive Mifeprex® (mifepristone) by pharmacy rather than standard care at clinic visit

Pharmacists

Pharmacists providing services at one of the study pharmacies during the study

Group Type OTHER

Training on mifepristone dispensing

Intervention Type OTHER

Pharmacists were offered a training on medication abortion and mifepristone dispensing

Interventions

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Mifepristone

Patients will receive Mifeprex® (mifepristone) by pharmacy rather than standard care at clinic visit

Intervention Type DRUG

Training on mifepristone dispensing

Pharmacists were offered a training on medication abortion and mifepristone dispensing

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Women seeking medication abortion through 70 days gestation
* Eligible for Mifeprex® at a study clinical site
* English or Spanish speaking
* Willing and able to participate in the study, including willing to go to the study pharmacy to obtain mifepristone

Exclusion Criteria

* Not pregnant
* Not seeking medication abortion
* Under the age of 15
* Contraindications for medication abortion

* All pharmacists providing services at one of the study pharmacies during the study are eligible for the pharmacist survey and interview.
Minimum Eligible Age

15 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of California, San Diego

OTHER

Sponsor Role collaborator

University of California, Davis

OTHER

Sponsor Role collaborator

University of Washington

OTHER

Sponsor Role collaborator

Kaiser Permanente

OTHER

Sponsor Role collaborator

Planned Parenthood of the Great Northwest and Hawaiian Islands

OTHER

Sponsor Role collaborator

Daniel Grossman

OTHER

Sponsor Role lead

Responsible Party

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Daniel Grossman

Professor in Dept ObGyn and Director of Advancing New Standards in Reproductive Health

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Daniel Grossman, MD

Role: PRINCIPAL_INVESTIGATOR

University of California, San Francisco

Locations

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Obstetrics and Gynecology Family Planning Clinic at University of California Davis

Sacramento, California, United States

Site Status

Women's Health Services at University of California San Diego

San Diego, California, United States

Site Status

Kaiser Permanente Northern California

San Francisco, California, United States

Site Status

Mt. Zion Women's Options Clinic, University

San Francisco, California, United States

Site Status

University of Washington

Seattle, Washington, United States

Site Status

Planned Parenthood Great Northwest, Hawai'i, Alaska, Indiana, Kentucky

Tacoma, Washington, United States

Site Status

Countries

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United States

References

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Kaller S, Morris N, Biggs MA, Baba CF, Rafie S, Raine-Bennett TR, Creinin MD, Berry E, Micks EA, Meckstroth KR, Averbach S, Grossman D. Pharmacists' knowledge, perspectives, and experiences with mifepristone dispensing for medication abortion. J Am Pharm Assoc (2003). 2021 Nov-Dec;61(6):785-794.e1. doi: 10.1016/j.japh.2021.06.017. Epub 2021 Jun 18.

Reference Type DERIVED
PMID: 34281806 (View on PubMed)

Grossman D, Baba CF, Kaller S, Biggs MA, Raifman S, Gurazada T, Rafie S, Averbach S, Meckstroth KR, Micks EA, Berry E, Raine-Bennett TR, Creinin MD. Medication Abortion With Pharmacist Dispensing of Mifepristone. Obstet Gynecol. 2021 Apr 1;137(4):613-622. doi: 10.1097/AOG.0000000000004312.

Reference Type DERIVED
PMID: 33706339 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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A128753

Identifier Type: -

Identifier Source: org_study_id

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