Non-pharmacological interventions to improve the acceptability of home-managed medical abortion in the UK: a scoping review
Michèle A Lefebvre, Maria Lewandowska, Kaye WellingsIntroduction
Home-managed medical abortions are the most common method of abortion in the UK. Although self-reported satisfaction is high, a minority of patients would not choose home management for a future abortion, and qualitative research on patient experiences reveals key areas where care could be improved. The aim of this scoping review was to present an overview of non-pharmacological interventions for home-managed medical abortion that could improve patient acceptability of the process in the UK.
Methods
We searched Medline, Embase, CINAHL Complete, Web of Science and Global Index Medicus databases in June 2023 for peer reviewed literature published in English between January 2013 and June 2023. We included primary research on non-pharmacological interventions for patients having a first-trimester medical abortion with home management. We charted study characteristics, intervention details and acceptability results and reported our findings by intervention type.
Results
We identified 10 studies that met our inclusion criteria. We described these interventions as abortion information-seeking, individual autonomy, social and community support, self-management of side effects and self-assessment of completion. Studies either presented findings about participants’ acceptability of the intervention or the intervention’s impact on abortion experience. One reported both. Two studies found significant improvements in patient experience—one in anxiety, emotional stress and preparedness during the abortion, and another in pain.
Conclusion
There are limited data on non-pharmacological interventions for home-managed medical abortion. Emerging evidence on patient experience in the UK should inform the design of novel interventions and the choice of indicators to assess an acceptable abortion experience.