Awareness of polycystic ovary syndrome among obstetrician-gynecologists and endocrinologists in Northern Europe

English version

Autoři: Terhi T. Piltonen ^aff001; Maria Ruokojärvi ^aff001; Helle Karro ^aff002; Linda Kujanpää ^aff001; Laure Morin-Papunen ^aff001; Juha S. Tapanainen ^aff001; Elisabet Stener-Victorin ^aff004; Inger Sundrström-Poromaa ^aff005; Angelica L. Hirschberg ^aff006; Pernille Ravn ^aff007; Dorte Glintborg ^aff008; Jan Roar Mellembakken ^aff009; Thora Steingrimsdottir ^aff010; Melanie Gibson-Helm ^aff011; Eszter Vanky ^aff012; Marianne Andersen ^aff014; Riikka K. Arffman ^aff001; Helena Teede ^aff011; Kobra Falah-Hassani ^aff001
Působiště autorů: Department of Obstetrics and Gynaecology, University of Oulu and Oulu University Hospital, Medical Research Centre, PEDEGO Research Unit, Oulu, Finland ^aff001; Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Tartu, Tartu, Estonia ^aff002; Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland ^aff003; Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden ^aff004; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden ^aff005; Department of Women’s and Children’s Health, Karolinska Institutet and Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden ^aff006; Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark ^aff007; Department of Endocrinology, Odense University Hospital, Odense, Denmark ^aff008; Department of Reproductive Medicine, Division of Gynaecology and Obstetrics, Oslo University Hospital, Oslo, Norway ^aff009; Department of Obstetrics and Gynecology, Landspitali University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland ^aff010; Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia ^aff011; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway ^aff012; Department of Obstetrics and Gynecology, St Olav's Hospital, University Hospital of Trondheim, Trondheim, Norway ^aff013; Department of Language and Culture, UiT—The Arctic University of Norway, Tromsø, Norway ^aff014
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0226074

Souhrn

Objective

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 non-fertility 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.

Klíčová slova:

Psychological and psychosocial issues – Physicians – Endocrinology – Health education and awareness – Iceland – Polycystic ovary syndrome – Estonia – Reproductive endocrinology

Zdroje

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