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Improving Access to Abortion in the Republic of Georgia

Phase 4
Conditions
Pregnancy Related
Abortion Early
Interventions
Registration Number
NCT04458558
Lead Sponsor
Center for Information and Counseling on Reproductive Health - Tanadgoma
Brief Summary

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.

Detailed Description

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.

Recruitment & Eligibility

Status
UNKNOWN
Sex
Female
Target Recruitment
120
Inclusion Criteria
  • Women seeking medical abortion through 58 days gestation
  • Eligible for medical abortion according to study provider's assessment
  • Able to receive physical mail
  • Have access to a phone
  • Be willing and able to consent to participate in the study
  • Be willing to follow study procedures
Exclusion Criteria
  • Not seeking medical abortion
  • Contraindications to medical abortion

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Medical abortion patientsMifepristoneOral mifepristone 200 mg followed by misoprostol 800 mcg administered buccally (at 24-48 hours following mifepristone).
Primary Outcome Measures
NameTimeMethod
Number of participants who report satisfactory experienceDay 14 following initial medical abortion visit

Number of participants who report being "satisfied" or "very satisfied" with the simplified medical abortion service delivery model

Number of providers who report satisfactory experienceEnd of the study, month 15

Number of providers who report being "satisfied" or "very satisfied" with the simplified medical abortion service delivery model

Secondary Outcome Measures
NameTimeMethod
Number of participants with adverse eventUp to 6 weeks after initial medical abortion visit

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

Number of particpants with adverse event associated with mailing of medical abortion medicationsUp to 6 weeks after initial medical abortion visit

Number of participants who had a problem (such as delayed and lost packages) receiving medical abortion medications by mail

Number of participants who refuse to receive medical abortion pills by mailEnd of the study, month 15

Number of participants who refuse to receive medical abortion pills by mail during the study period

Number of participants with a complete abortion with medication alone and who do not require additional interventions to complete the procedureUp to 6 weeks after initial medical abortion visit

Number of participants who report that their abortion is complete as assessed by the multi-level pregnancy test and medical history.

Cost associated with the simplified medical abortion service delivery modelUp to 6 weeks after initial medical abortion visit

Cost savings associated with participant travel to the clinic and cost of the standard care at the clinic.

Trial Locations

Locations (3)

Batumi Medical Center

🇬🇪

Batumi, Georgia

Clinic Elite

🇬🇪

Zestap'oni, Georgia

David Gagua Clinic

🇬🇪

Tbilisi, Georgia

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