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Awareness of polycystic ovary syndrome among obstetrician-gynecologists and endocrinologists in Northern Europe
journal contribution
posted on 2022-03-22, 22:46 authored by TT Piltonen, M Ruokojärvi, H Karro, L Kujanpää, L Morin-Papunen, JS Tapanainen, E Stener-Victorin, I Sundrström-Poromaa, AL Hirschberg, P Ravn, D Glintborg, JR Mellembakken, T Steingrimsdottir, Melanie Gibson-HelmMelanie Gibson-Helm, E Vanky, M Andersen, RK Arffman, H Teede, K Falah-HassaniObjective To date, little is known about differences in the knowledge, diagnosis making and treatment strategies of health care providers regarding polycystic ovary syndrome (PCOS) across different disciplines in countries with similar health care systems. To inform guideline translation, we aimed to study physician reported awareness, diagnosis and management of PCOS and to explore differences between medical disciplines in the Nordic countries and Estonia. Methods This cross-sectional survey was conducted among 382 endocrinologists and obstetrician-gynaecologists in the Nordic countries and Estonia in 2015-2016. Of the participating physicians, 43% resided in Finland, 18% in Denmark, 16% in Norway, 13% in Estonia, and 10% in Sweden or Iceland, and 75% were obstetrician-gynaecologists. Multivariable logistic regression models were run to identify health care provider characteristics for awareness, diagnosis and treatment of PCOS. Results Clinical features, lifestyle management and comorbidity were commonly recognized in women with PCOS, while impairment in psychosocial wellbeing was not well acknowledged. Over two-thirds of the physicians used the Rotterdam diagnostic criteria for PCOS. Medical endocrinologists more often recommended lifestyle management (OR = 3.6, CI 1.6-8.1) or metformin (OR = 5.0, CI 2.5-10.2), but less frequently OCP (OR = 0.5, CI 0.2-0.9) for nonfertility concerns than general obstetrician-gynaecologists. The physicians aged <35 years were 2.2 times (95% CI 1.1-4.3) more likely than older physicians to recommend lifestyle management for patients with PCOS for fertility concerns. Physicians aged 46-55 years were less likely to recommend oral contraceptive pills (OCP) for patients with PCOS than physicians aged >56 (adjusted odds ratio (OR) = 0.4, 95% CI 0.2-0.8). Conclusion Despite well-organized healthcare, awareness, diagnosis and management of PCOS is suboptimal, especially in relation to psychosocial comorbidities, among physicians in the Nordic countries and Estonia. Physicians need more education on PCOS and evidence-based information on Rotterdam diagnostic criteria, psychosocial features and treatment of PCOS, with the recently published international PCOS guideline well needed and welcomed.
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Piltonen, T. T., Ruokojärvi, M., Karro, H., Kujanpää, L., Morin-Papunen, L., Tapanainen, J. S., Stener-Victorin, E., Sundrström-Poromaa, I., Hirschberg, A. L., Ravn, P., Glintborg, D., Mellembakken, J. R., Steingrimsdottir, T., Gibson-Helm, M., Vanky, E., Andersen, M., Arffman, R. K., Teede, H. & Falah-Hassani, K. (2019). Awareness of polycystic ovary syndrome among obstetrician-gynecologists and endocrinologists in Northern Europe. PLoS ONE, 14(12), e0226074-e0226074. https://doi.org/10.1371/journal.pone.0226074Publisher DOI
Journal title
PLoS ONEVolume
14Issue
12Publication date
2019-12-01Pagination
e0226074-e0226074Publisher
Public Library of Science (PLoS)Publication status
PublishedOnline publication date
2019-12-26ISSN
1932-6203eISSN
1932-6203Language
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Keywords
AdultComorbidityContraceptives, OralCross-Sectional StudiesEndocrinologistsEuropeFemaleHumansLife StyleMaleMetforminMiddle AgedPhysiciansPolycystic Ovary SyndromePsychotherapyRegression AnalysisSurveys and QuestionnairesContraception/ReproductionClinical ResearchReproductive health and childbirth3 Good Health and Well BeingGeneral Science & TechnologyObstetrics and Gynaecology
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