A systematic review of models of care for polycystic ovary syndrome highlights the gap in the literature, especially in developing countries.

Jacky Boivin, Eka Melson, Meri Davitadze, Kashish Malhotra, Aya Mousa, Helena Teede, Mala Thondan, Chau Thien Tay, Punith Kempegowda

Journal: Frontiers in endocrinology 2023;14():1217468

PMID: 37614710

Abstract

INTRODUCTION

The aim of the study was to identify available polycystic ovary syndrome (PCOS) models of care (MoCs) and describe their characteristics and alignment with the international PCOS guideline.

METHODS

Ovid MEDLINE, All EBM, PsycINFO, Embase, and CINAHL were searched from inception until 11 July 2022. Any study with a description of a PCOS MoC was included. Non-evidence-based guidelines, abstracts, study protocols, and clinical trial registrations were excluded. We also excluded MoCs delivered in research settings to minimize care bias. Meta-analysis was not performed due to heterogeneity across MoCs. We describe and evaluate each MoC based on the recommendations made by the international evidence-based guideline for assessing and managing PCOS.

RESULTS

Of 3,671 articles, six articles describing five MoCs were included in our systematic review. All MoCs described a multidisciplinary approach, including an endocrinologist, dietitian, gynecologist, psychologist, dermatologist, etc. Three MoCs described all aspects of PCOS care aligned with the international guideline recommendations. These include providing education on long-term risks, lifestyle interventions, screening and management of emotional well-being, cardiometabolic diseases, and the dermatological and reproductive elements of PCOS. Three MoCs evaluated patients' and healthcare professionals' satisfaction, with generally positive findings. Only one MoC explored the impact of their service on patients' health outcomes and showed improvement in BMI.

CONCLUSION

There is limited literature describing PCOS MoCs in routine practice. Future research should explore developing cost-effective co-created multidisciplinary PCOS MoCs globally. This may be facilitated by the exchange of best practices between institutions with an established MoC and those who are interested in setting one up.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=346539, identifier CRD42022346539.

Copyright © 2023 Melson, Davitadze, Malhotra, PCOS SEva working group, Mousa, Teede, Boivin, Thondan, Tay and Kempegowda.

Address: Leicester Diabetes Centre, University of Leicester, Leicester, United Kingdom.; Department of Diabetes and Endocrinology, Clinic NeoLab, Tbilisi, Georgia.; Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.; Dayanand Medical College and Hospital, Punjab, India.; Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC, Australia.; School of Psychology, Cardiff University, Cardiff, Wales, United Kingdom.; Primary Care, Harp Family Medical Centre, Melbourne, VIC, Australia.; Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
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