A systematic review of models of care for polycystic ovary syndrome highlights the gap in the literature, especially in developing countries
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Date
2023
Authors
Melson, E.
Davitadze, M.
Malhotra, K.
Mousa, A.
Teede, H.
Boivin, J.
Thondan, M.
Tay, C.T.
Kempegowda, P.
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Journal article
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Frontiers in Endocrinology, 2023; 14:1217468-1-1217468-12
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Eka Melson, Meri Davitadze, Kashish Malhotra, PCOS SEva working group, Aya Mousa, Helena Teede, Jacky Boivin, Mala Thondan, Chau Thien Tay and Punith Kempegowda
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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 evidencebased 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.
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PUBLISHED 19 July 2023
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© 2023 Melson, Davitadze, Malhotra, PCOS SEva working group, Mousa, Teede, Boivin, Thondan, Tay and Kempegowda. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.