Grant: Travel Awards - Institute Community Support

Policy, regulatory and care delivery models for medical abortion vary throughout high-income countries. Through comparison and discussion, this international panel will present new knowledge on best practice alternatives. We will introduce innovative implementation research models, to accelerate uptake of mifepristone in policy and practice. In Canada, we sought to understand facilitators and barriers to implementation of mifepristone nationally, and used integrated knowledge translation (iKT) to support policy and practice changes. This prospective mixed-methods implementation study involved a national sample of physicians and pharmacists, recruited via an online training program and a Community of Practice website. Surveys were conducted at baseline and at 6 months and qualitative data were collected from electronic interactions. Survey participants and a purposeful sample of decision makers were invited to participate in in-depth interviews. Barriers to implementation of mifepristone identified included both practice and policy factors, including: mandated physician-only dispensing and pharmacist training, inadequate payment mechanisms, and confusion about changing regulations. During the study period, our iKT strategies (evidence briefs and GIS-maps, face-to-face meetings, and regular correspondence) contributed to identification and removal of the federal requirements for observed dosing, practitioner training, practitioner registration, and physician-only prescribing and dispensing. This implementation study accelerated health system change through concurrent identification and mitigation of barriers to implementation of mifepristone in Canada.