- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT01827995
Simplified Medical Abortion in Rural India
13. august 2014 oppdatert av: Kristina Gemzell Danielsson, Karolinska Institutet
It is estimated that around 50 000 women die every year due to consequences of unsafe abortion (Singh et al, 2009).
A majority of these deaths occur in low-income countries where access to safe abortion care is limited.
Unplanned pregnancy and unsafe abortion thus place a huge burden on scarce medical resources.
Any improvement in Comprehensive Abortion Care (CAC) would mean important improvements for the concerned women and their families (Singh, 2006) as well as for the societies at large.
Recommended improvements concern increased access to the safest and most cost-effective methods such as medical abortion provided at primary level facilities (Singh et al, 2009).
A Cochrane Review concludes that most randomised controlled trials within the field of medical abortion are conducted in high-income settings with good access to emergency health care services (Kulier et al, 2004).
A simplified regime for medical abortion, which could be used at primary level facilities, would contribute to the reduction of maternal mortality and morbidity related to unsafe abortions globally.
However, there is a knowledge gap in order to determine if a simplified follow up of medical abortion is equally effective as the standard procedure in a low-income setting.
The results will provide evidence-based information to be used in revising training and service delivery guidelines' in order to reduce maternal mortality and morbidity in both low and high-income setting.
Studieoversikt
Status
Fullført
Forhold
Intervensjon / Behandling
Studietype
Intervensjonell
Registrering (Faktiske)
731
Fase
- Fase 4
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
-
-
Rajasthan
-
Udaipur, Rajasthan, India, 313001
- ARTH
-
-
Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
18 år og eldre (Voksen, Eldre voksen)
Tar imot friske frivillige
Nei
Kjønn som er kvalifisert for studier
Hunn
Beskrivelse
Inclusion Criteria:
- women presenting with a positive urine test and uterine size equivalent to or up to 9 +0 weeks (63 days) of gestation
- opting for medical abortion and
- residing in an area where follow-up is feasible.
- woman agrees for a follow up contact at 10-14 days.
Exclusion Criteria:
- women with contraindications to medical abortions,
- haemoglobin level less than 85 (Hb < 85) and
- age less than 18 years.
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Helsetjenesteforskning
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
---|---|
Annen: Duo test
Self assessment
|
Intervention group: Simplified followup Mifepristone at outpatient clinic, followed by the administration of misoprostol 24-48 hours later (in the clinic or at home).
The women will not return to the clinic for routine follow up visit, but are given instructions on how to use a checklist and a low sensitivity pregnancy test around day 10-14.
They are asked only to return if they have any health problems or screen positively.
The low sensitivity urinary-hCG (with HCG of 1000 IU/ml) test will be used.
Women will be provided the pregnancy test free of cost along with a pictorial checklist.
A research assistant or a nurse will explain in detail how to use the pregnancy test as well as the checklist, and provide phone numbers in case of any questions or doubts.
Follow-up interviews will be conducted through home visits or phone (if woman has one) during the next 1-2 days to screen for on-going pregnancies and assess acceptability the self-assessment.
Andre navn:
|
Annen: Routine follow up
Follow up in the clinic
|
Follow up in the clinic
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Efficacy
Tidsramme: At 10-14 days follow up
|
efficacy of self-assessment, measured as the rate of complete abortion, relative to routine follow up .
The percentage of women requiring surgical intervention, extra visits and administration of additional misoprostol will be used to monitor incomplete abortion.
|
At 10-14 days follow up
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Safety
Tidsramme: Up to 10-14 days Follow Up
|
unscheduled visits for various adverse events/complications, side effects of medical abortion including infections, bleeding, pain
|
Up to 10-14 days Follow Up
|
Andre resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
contraceptive uptake
Tidsramme: at approx. 2 weeks after abortion (at FU)
|
Number of women who have started a contraceptive method or is planning to start a method
|
at approx. 2 weeks after abortion (at FU)
|
time consumption
Tidsramme: at 10-14 days Follow Up
|
Time spent for clinical visits/contacts
|
at 10-14 days Follow Up
|
Acceptability
Tidsramme: at 10-14 days follow up
|
Acceptability (evaluated by a questionnaire)of home self assessment of complete pregnancy using a low sensitivity u-hCG test
|
at 10-14 days follow up
|
Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Sponsor
Etterforskere
- Hovedetterforsker: Sharad Iyengar, MD, ARTH
Publikasjoner og nyttige lenker
Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.
Generelle publikasjoner
- Paul M, Iyengar SD, Essen B, Gemzell-Danielsson K, Iyengar K, Bring J, Klingberg-Allvin M. Does mode of follow-up influence contraceptive use after medical abortion in a low-resource setting? Secondary outcome analysis of a non-inferiority randomized controlled trial. BMC Public Health. 2016 Oct 17;16(1):1087. doi: 10.1186/s12889-016-3726-1.
- Paul M, Iyengar K, Essen B, Gemzell-Danielsson K, Iyengar SD, Bring J, Soni S, Klingberg-Allvin M. Acceptability of Home-Assessment Post Medical Abortion and Medical Abortion in a Low-Resource Setting in Rajasthan, India. Secondary Outcome Analysis of a Non-Inferiority Randomized Controlled Trial. PLoS One. 2015 Sep 1;10(9):e0133354. doi: 10.1371/journal.pone.0133354. eCollection 2015.
- Iyengar K, Paul M, Iyengar SD, Klingberg-Allvin M, Essen B, Bring J, Soni S, Gemzell-Danielsson K. Self-assessment of the outcome of early medical abortion versus clinic follow-up in India: a randomised, controlled, non-inferiority trial. Lancet Glob Health. 2015 Sep;3(9):e537-45. doi: 10.1016/S2214-109X(15)00150-3.
- Paul M, Iyengar K, Iyengar S, Gemzell-Danielsson K, Essen B, Klingberg-Allvin M. Simplified follow-up after medical abortion using a low-sensitivity urinary pregnancy test and a pictorial instruction sheet in Rajasthan, India--study protocol and intervention adaptation of a randomised control trial. BMC Womens Health. 2014 Aug 15;14:98. doi: 10.1186/1472-6874-14-98.
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart
1. april 2013
Primær fullføring (Faktiske)
1. mai 2014
Studiet fullført (Faktiske)
1. juni 2014
Datoer for studieregistrering
Først innsendt
3. april 2013
Først innsendt som oppfylte QC-kriteriene
5. april 2013
Først lagt ut (Anslag)
10. april 2013
Oppdateringer av studieposter
Sist oppdatering lagt ut (Anslag)
15. august 2014
Siste oppdatering sendt inn som oppfylte QC-kriteriene
13. august 2014
Sist bekreftet
1. august 2014
Mer informasjon
Begreper knyttet til denne studien
Andre studie-ID-numre
- WDuo2013
Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .
Kliniske studier på Svangerskap
-
King's College Hospital NHS TrustEuropean Association for the Study of the LiverRekrutteringSkrumplever, lever | HELLP syndrom | Intrahepatisk kolestase ved graviditet | Graviditetssykdom | AFLP - Acute Fatty Liver of PregnancyStorbritannia
Kliniske studier på Self assessment
-
Wake Forest University Health SciencesFullførtSelf Geriatric Assessment Measure (SGAM)Forente stater
-
University of ArkansasFullførtMental HelseForente stater
-
Centre Hospitalier Universitaire, AmiensRekrutteringHypnose | Poliklinisk kirurgi | Lokalbedøvelse | ANSIKTFrankrike
-
University of WashingtonNational Institute of Nursing Research (NINR); East Carolina UniversityHar ikke rekruttert ennåImplanterbar defibrillatorbruker | Stressreaksjon | Ptsd | Stressmestring | Sosial kognitiv teoriForente stater
-
Karamanoğlu Mehmetbey UniversityKaraman Training and Research HospitalFullført
-
Thomas Jefferson UniversityFullførtHematopoetisk og lymfoid celle-neoplasma | Ondartet fast neoplasmaForente stater
-
University of WinchesterUniversity College DublinFullførtSlag | Fysisk aktivitet | Gangart, hemiplegiskStorbritannia
-
University of MichiganNational Institutes of Health (NIH); National Institute on Aging (NIA); Blue...Fullført
-
University of MichiganFullført
-
University Hospital, LilleFullførtKognitivt symptom | Evalueringer, Diagnostisk selvFrankrike