Endocrine Abstracts

Introduction : Polycystic ovary syndrome (PCOS) is associated with broad reproductive, metabolic and psychological complications, as well as significant heterogeneity in presentation between and within individuals across the lifespan. Therefore, there is a need for a multidisciplinary approach. A model of care (MoC) is conceptualised as an overarching provision of care that is codesigned with end-users and aligns with evidence-based practice and defined standards. The international PCOS guideline from 2018 recommends to ensure best practices while providing care for women and individuals with PCOS. Exploration of existing MoCs for PCOS can help identify and share learnings from current practice.

Aim : To perform a systematic review to identify available PCOS MoCs and describe their characteristics and alignment with the international PCOS guideline.

Methods : This systematic review was prospectively registered on PROSPERO CRD42022346539. OVID MEDLINE, All EBM, PsycInfo, EMBASE, and CINAHL were searched from inception until 11 July 2022. Any English study with a detailed description of a PCOS MoC was included. Abstracts, study protocols, and clinical trial registrations were excluded. Data extracted included the service name and detailed descriptions of the model, specialities involved, services provided in alignment with the PCOS guideline and evaluations. Data were synthesised narratively.

Results : Of 3670 articles, five articles describing four MoCs were included in our systematic review—two from Australia, three from the US, and none from developing countries. All MoCs described a multidisciplinary approach ranging from 4-8 specialties including a health nurse, dietitian, endocrinologist, gynaecologist, psychologist, dermatologist, etc. Two MoCs—Monash Health state-wide integrated PCOS service and the Multidisciplinary clinic for PCOS at Children’s Hospital Colorado—described all aspects of PCOS care aligning with the international guideline. These include providing education on long-term risks, lifestyle interventions, screening and management of emotional well-being, cardiometabolic diseases, and dermatological and reproductive elements of PCOS. Two MoCs were evaluated via focused-group discussions, semi-structured interviews, and surveys to understand 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 and weight.

Conclusion : There is limited literature describing PCOS MoCs in routine practice. Future research should explore the various PCOS MoCs globally, particularly from low- and middle-income countries, and their alignment with international guidelines as well as focusing on patient satisfaction and needs. This may facilitate the exchange of best practices between institutions and support the development of a best-practice framework in PCOS care.