Telemedicine early medical abortion at home: evaluation

Appendix 1 – WP2 Survey Questions

Which Health board are you responding on behalf of?

• Ayrshire & Arran
• Borders
• Dumfries & Galloway
• Fife
• Forth Valley
• Grampian
• Greater Glasgow & Clyde
• Highland
• Lanarkshire
• Lothian
• Orkney
• Shetland
• Tayside
• Western Isles

How do patients access your service?

• Self-referral
• GP referral
• Referrals from other services (e.g. Gynaecology/Sexual Health)
• Other

How many new referrals do you have per week (on average)?

What information are patients directed to/sent prior to their appointment?

• Own clinic website
• Other website
• Text messages
• Paper letter
• Paper information sheet
• Nothing
• Other

Which days of the week do you have clinics?

• Monday
• Tuesday
• Wednesday
• Thursday
• Friday
• Saturday
• Sunday

What time of day do you have clinics?

• Morning
• Afternoon
• Evening
• Changes depending on the day
• Other

How do you usually conduct assessment appointments?

• In-person
• Telephone
• Video/NearMe
• Other

On average, how many assessment appointments can you provide per week?

On average, how long does it take from referral to assessment appointment?

• Same Day
• Within 48 hours
• Between 48 hours and 7 days
• Between 7 days and 14 days
• Longer than 14 days
• Other

What systems are used for the assessment consultation?

• Paper notes
• NaSH
• TRAK
• Paper Prescriptions
• Electronic Prescriptions
• Other

Do you conduct any of the following investigations before abortion?

• Ultrasound Scan
  • Yes - all patients
  • Only if clinical indications
  • Rarely or never
• Full Blood Count
  • Yes - all patients
  • Only if clinical indications
  • Rarely or never
• Blood Group
  • Yes - all patients
  • Only if clinical indications
  • Rarely or never
• HIV/Syphilis blood test
  • Yes - all patients
  • Only if clinical indications
  • Rarely or never
• Chlamydia/Gonorrhoea swab test
  • Yes - all patients
  • Only if clinical indications
  • Rarely or never
• Serum hCG
  • Yes - all patients
  • Only if clinical indications
  • Rarely or never

On average, how many patients receive ultrasound scans PRE- abortion each week

On average, how many patients receive blood tests PRE-abortion each week

What types of abortion care are offered via your service?

• Medical abortion at home (patient passes pregnancy at home)
• Medical abortion in hospital (patient passes pregnancy in hospital)
• Surgical abortion in outpatient clinic (incl. MVA)
• Surgical abortion in hospital/day surgery unit
• Other

On average, how many medical abortions at home are performed per week?

For medical abortions at home only:

• Where do patients take Mifepristone?
  • Mostly at home
  • Half take at home, Half take in clinic
  • Mostly in clinic
• Where do patients take Misoprostol?
  • Mostly at home
  • Half take at home, Half take in clinic
  • Mostly in clinic

For medical abortions at home only, what supplementary medications are typically given from clinic?

• Paracetamol
• Ibuprofen
• Codeine
• Dihydrocodeine
• Morphine
• Cyclizine
• Ondansetron
• Metoclopramide
• Doxycycline
• Azithromycin
• Other

For medical abortions at home only, what is the upper gestational limit for this?

• 8 weeks + 6 days
• 9 weeks + 6 days
• 10 weeks + 6 days
• 11 weeks + 6 days
• Other

On average, how many other kinds of abortions are performed per week?

What is the maximum gestation for any kind of abortion delivered by your service in area?

• 8 weeks + 6 days
• 9 weeks + 6 days
• 10 weeks + 6 days
• 11 weeks + 6 days
• 12 weeks + 6 days
• 13 weeks + 6 days
• 14 weeks + 6 days
• 15 weeks + 6 days
• 16 weeks + 6 days
• 17 weeks + 6 days
• 18 weeks + 6 days
• 19 weeks + 6 days
• Other

Which of the following tests are used POST-abortion?

• Ultrasound Scan
  • Yes - all patients
  • Only if clinical indications
  • Rarely or never
• Serum hCG
  • Yes - all patients
  • Only if clinical indications
  • Rarely or never
• Low Sensitivity Urine Pregnancy Test (positive >1000iU hCG)
  • Yes - all patients
  • Only if clinical indications
  • Rarely or never
• High Sensitivity Urine Pregnancy Test (positive >50iU hCG)
  • Yes - all patients
  • Only if clinical indications
  • Rarely or never

Do you contact the patient's GP?

• Yes - routinely
• Sometimes
• Rarely/Never

Do you have a 'follow up' or 'office' team who manage post-abortion follow up/patient queries?

• Yes
• No
• Other

Do you routinely audit complications/further unscheduled contact?

• Yes
• No
• Other

For post-abortion contraception, how do patients access this

• CHC
  • Included in medication pack
  • Rapid Access Clinic (via abortion service)
  • Routine Contraception Clinic (via SRH service)
  • Directed to GP
• POP
  • Included in medication pack
  • Rapid Access Clinic (via abortion service)
  • Routine Contraception Clinic (via SRH service)
  • Directed to GP
• DMPA injection
  • Included in medication pack
  • Rapid Access Clinic (via abortion service)
  • Routine Contraception Clinic (via SRH service)
  • Directed to GP
• Subdermal Implant Included in medication pack
  • Rapid Access Clinic (via abortion service)
  • Routine Contraception Clinic (via SRH service)
  • Directed to GP
• Intrauterine Contraception
  • Rapid Access Clinic (via abortion service)
  • Routine Contraception Clinic (via SRH service)
  • Directed to GP