Quality and safety in the literature: January 2023

© Author(s) (or their employer(s)) 2023. No commercial reuse. See rights and permissions. Published by BMJ. A TELEMEDICINE MODEL FOR ABORTION IN SOUTH AFRICA: A RANDOMISED, CONTROLLED, NONINFERIORITY TRIAL Lancet. 27 Aug 2022 Abortion care, pursued for a variety of reasons (eg, health of the woman, viability of the fetus, pregnancy resulting from sexual assault and unintended pregnancy), is often considered to be fundamental to women’s health. Unsafe abortion can lead to a variety of health risks including haemorrhage, infection and uterine perforation, whereas access to safe abortion has been shown to decrease mortality. 2 Among many other variables, patient sociodemographic factors such as home location, financial status and access to transportation may play a role in abortion care. For some women, changing political landscapes have made abortion care difficult to obtain. For others, distance from abortion providers creates a physical barrier to safe care. Still others may be reticent to engage in healthcare systems due to abortionrelated stigma. 5 A magnifier of multiple socioeconomic challenges, the COVID19 pandemic has further strained access to safe care, as medical attention has been shifted toward the pandemic and travel has become more limited in many regions in the world. One important consequence of the COVID19 pandemic has been a rapid acceleration in the adoption of virtual care, which has been used both with higher prevalence and in innovative ways. However, research into understanding the impacts of telemedicine, particularly as it applies to abortion care, has typically been conducted in resourcerich settings. For example, an approach to hybrid abortion care, using onetoone counselling via telephone and selective use of ultrasound inperson, was implemented in Europe in response to the pandemic. Observational data from these programmes suggest similar clinical outcomes to traditional, inclinic care. However, telemedicine models of abortion care had not been studied in randomised, controlled trials anywhere and particularly not in resourcelimited settings. Healthcare quality and safety span multiple topics across the spectrum of academic and clinical disciplines. Keeping abreast of the rapidly growing body of work can be challenging. In this series, we provide succinct summaries of selected relevant studies published in the last several months. Some articles will focus on a particular theme, whereas others will highlight unique publications from highimpact medical journals.