scholarly journals Barriers and Facilitators to the Implementation of Evidence-Based Lifestyle Management in Polycystic Ovary Syndrome: A Narrative Review

2019 ◽  
Vol 7 (7) ◽  
pp. 76 ◽  
Author(s):  
Blackshaw ◽  
Chhour ◽  
Stepto ◽  
Lim
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Healthcare Providers ◽  
Implementation Strategies ◽  
Barriers And Facilitators ◽  
Evidence Based ◽  
Ovary Syndrome ◽  
Lifestyle Management ◽  
Increased Risk ◽  
Evidence Based Guideline

Polycystic ovary syndrome (PCOS) is a complex condition that involves metabolic, psychological and reproductive complications. Insulin resistance underlies much of the pathophysiology and symptomatology of the condition and contributes to long term complications including cardiovascular disease and diabetes. Women with PCOS are at increased risk of obesity which further compounds metabolic, reproductive and psychological risks. Lifestyle interventions including diet, exercise and behavioural management have been shown to improve PCOS presentations across the reproductive, metabolic and psychological spectrum and are recommended as first line treatment for any presentation of PCOS in women with excess weight by the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome 2018. However, there is a paucity of research on the implementation lifestyle management in women with PCOS by healthcare providers. Limited existing evidence indicates lifestyle management is not consistently provided and not meeting the needs of the patients. In this review, barriers and facilitators to the implementation of evidence-based lifestyle management in reference to PCOS are discussed in the context of a federally-funded health system. This review highlights the need for targeted research on the knowledge and practice of PCOS healthcare providers to best inform implementation strategies for the translation of the PCOS guidelines on lifestyle management in PCOS.

scholarly journals Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome

2018 ◽  
Vol 89 (3) ◽  
pp. 251-268 ◽  
Author(s):  
Helena J. Teede ◽  
Marie L. Misso ◽  
Michael F. Costello ◽  
Anuja Dokras ◽  
Joop Laven ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Evidence Based ◽  
Ovary Syndrome ◽  
International Evidence ◽  
Evidence Based Guideline

scholarly journals Dietary and Physical Activity Behaviors in Women with Polycystic Ovary Syndrome per the New International Evidence-Based Guideline

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2711 ◽  
Author(s):  
Annie W. Lin ◽  
Maryam Kazemi ◽  
Brittany Y. Jarrett ◽  
Heidi Vanden Brink ◽  
Kathleen M. Hoeger ◽  
...  
Keyword(s):  
Physical Activity ◽  
Polycystic Ovary Syndrome ◽  
Dietary Intake ◽  
Diet Quality ◽  
Polycystic Ovary ◽  
Healthy Eating Index ◽  
Evidence Based ◽  
Ovary Syndrome ◽  
International Evidence ◽  
Evidence Based Guideline

Lifestyle modifications are recommended as first-line therapy in polycystic ovary syndrome (PCOS). However, usual dietary and physical activity (PA) behaviors of women with PCOS remain uncertain, likely owing to controversy in diagnostic criteria. Our objective was to contrast the usual dietary and PA behaviors of women with PCOS (n = 80) diagnosed by the 2018 International Evidence-based Guideline for the Assessment and Management of PCOS to that of controls (n = 44). Study outcomes were dietary intake, diet quality (Healthy Eating Index-2015), and PA (questionnaire, waist-worn accelerometers). Women with PCOS met the acceptable macronutrient distribution ranges for carbohydrate, fat, and protein, but did not meet the recommended dietary reference intakes for vitamin D (mean (95% confidence interval); 6 (5–7) μg/d), vitamin B9 (275 (252–298) μg/d), total fiber (24 (22–26) g/d), or sodium (4.0 (3.6–4.4) g/d). Women with PCOS also met the US recommendations for PA. No differences were detected in dietary intake, diet quality, or PA levels between groups (p ≥ 0.11). In conclusion, women with and without PCOS have comparable dietary and PA behaviors. A lack of unique targets for dietary or PA interventions supports the position of the new guideline to foster healthy lifestyle recommendations for the management of PCOS.

scholarly journals Polycystic Ovary Syndrome: It is time to change the approach in diagnosis and management

IJEDO ◽  
2021 ◽  
Vol 3 ◽  
pp. 12-14
Author(s):  
Carole Wehbe Chidiac
Keyword(s):  
Eating Disorders ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Lifestyle Changes ◽  
Reproductive Age ◽  
Evidence Based ◽  
Emotional Wellbeing ◽  
Ovary Syndrome ◽  
Communication Preferences ◽  
Evidence Based Guideline

Polycystic ovary syndrome (PCOS) is a common and very distressing condition in women of reproductive age. International evidence-based guideline for the assessment and management of polycystic ovary syndrome was published in 2018, with a governance including an international advisory board from six continents. The global guideline has provided a well-rounded and all-inclusive synopsis of all aspects of PCOS. Recommendations made are clear and should help eliminate areas of conflict. The addition of large sections addressing lifestyle and emotional wellbeing puts the prevalence of eating disorders in PCOS in the spotlight and strengthens the importance of looking at the patient as a whole rather than a collection of individual symptoms and problems to solve. This commentary focuses on the evidence against many unnecessary and even harmful practices we still frequently encounter: the diagnostic criteria in teenagers, the lack of optimal ultrasound reporting, the unnecessary recommendation for non-evidence-based diets, and the harmful effects of untimely discussions disregarding women’s priorities, communication preferences, beliefs culture and mental health. Last but not least, although screening for eating disorders has been recommended by many medical societies, especially before any triggering discussion about lifestyle changes, it is still rarely done in clinical practice.

An Analysis on the Implementation of the Evidence-based PCOS Lifestyle Guideline: Recommendations from Women with PCOS

2021 ◽  
Vol 39 (03/04) ◽  
pp. 153-160
Author(s):  
Siew Lim ◽  
Breanna Wright ◽  
Melissa Savaglio ◽  
Denise Goodwin ◽  
Stephanie Pirotta ◽  
...  
Keyword(s):  
Peer Support ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Evidence Based ◽  
Structured Interviews ◽  
Ovary Syndrome ◽  
Implementation Plan ◽  
Lifestyle Management ◽  
Evidence Based Guideline ◽  
Recurrent Theme

AbstractPolycystic ovary syndrome (PCOS) is the most common endocrinological disorder affecting women of reproductive age, affecting 8–13% in this group. Women with PCOS are more likely to have excess BMI, which in turn exacerbates the symptoms of PCOS in these women. The latest evidence-based guideline recommends lifestyle management as the first-line treatment for PCOS. However, the implementation of this recommendation through health services faces a significant challenge. As part of the mapping of the implementation plan for lifestyle management in PCOS, citizen panels and semi-structured interviews were conducted to capture the voices of consumers. Women with PCOS expressed the need for multidisciplinary, integrated care as a recurrent theme. Other important considerations included health professionals who listen and are open to learning about PCOS, the empowerment of women to self-manage PCOS and the provision of peer support. Women with PCOS also expressed the key recommendation of focusing on practical skills when providing lifestyle advice. Within that, both individual and group lifestyle sessions were valued for privacy and peer support respectively and delivery by a dietitian is preferred. These recommendations by women with PCOS should be considered when developing the implementation plan for the PCOS lifestyle guideline.

scholarly journals Barriers and Facilitators to Weight and Lifestyle Management in Women with Polycystic Ovary Syndrome: General Practitioners’ Perspectives

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 1024 ◽  
Author(s):  
Alexis Arasu ◽  
Lisa J Moran ◽  
Tracy Robinson ◽  
Jacqueline Boyle ◽  
Siew Lim
Keyword(s):  
Polycystic Ovary Syndrome ◽  
General Practitioners ◽  
Health Professionals ◽  
Allied Health ◽  
Polycystic Ovary ◽  
Barriers And Facilitators ◽  
Structured Interviews ◽  
Ovary Syndrome ◽  
Allied Health Professionals ◽  
Lifestyle Management

Background: Weight and lifestyle management is advocated as the first-line treatment for polycystic ovary syndrome (PCOS) by evidence-based guidelines. Current literature describes both systems- and individual-related challenges that general practitioners (GPs) face when attempting to implement guideline recommendations for lifestyle management into clinical practice for the general population. The GPs’ perspective in relation to weight and lifestyle advice for PCOS has not been captured. Methods: Fifteen GPs were recruited to take part in semi-structured interviews. NVIVO software was used for qualitative analysis. Results: We report that GPs unanimously acknowledge the importance of weight and lifestyle management in PCOS. Practice was influenced by both systems-related and individual-related facilitators and barriers. Individual-related barriers include perceived lack of patient motivation for weight loss, time pressures, lack of financial reimbursement, and weight management being professionally unrewarding. System-related barriers include costs of accessing allied health professionals and unavailability of allied health professionals in certain locations. Individual-related facilitators include motivated patient subgroups such as those trying to get pregnant and specific communication techniques such as motivational interviewing. System-related facilitators include the GP’s role in chronic disease management. Conclusions: This study contributes to the understanding of barriers and facilitators that could be addressed to optimize weight and lifestyle management in women with PCOS in primary care.

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