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


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
doi: 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:

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


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 12