A Long-term Evaluation of a Required Reproductive Health Training Rotation with Opt-out Provisions for Family Medicine Residents

training sessions on knowledge, referrals and values clarification on medication abortion (MA) was used to document the efficacy of the intervention within a model of harm reduction to prevent unsafe abortion. Methods: Fifty-five of 80 trained pharmacists completed anonymous surveys in 2010; 53 pharmacists were interviewed 1 year later to measure the retention and effectiveness of the intervention. Unlinked questionnaires were analyzed for changes over time. Results: Questions were categorized into the three harm-reduction principles: neutrality, humanism and pragmatism. The principle of neutrality, refraining from judgment, was demonstrated with results showing improved attitudes, willingness to share information about abortion and a decreased likelihood of providing misinformation. The principle of humanism was measured by changes in abortion referrals. Finally, pragmatism, the view that women will engage in unsafe abortion and that eradication is likely impossible, led some pharmacists to become direct providers of medication. The percentage of pharmacists dispensing ineffective drugs decreased from 30% to 25%; pb0.001. Conversely, stocking of misoprostol (NS), referral to an abortion-providing facility (p=.02), giving information about pregnancy termination (NS) and the sale of MA drugs to clients (0.02) all increased from baseline to endline. Conclusions: A follow-up survey provided an opportunity to examine effectiveness and retention. Studying these results in a harm-reduction framework contributes further evidence to promote this work in its relationship to the prevention of unsafe abortion.