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Joshi, Beena
- Knowledge and Management Practices About Polycystic Ovarian Syndrome Among Health Care Providers in Mumbai, India: A Cross-Sectional Study
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Objectives: To assess knowledge about PCOS diagnosis and management by Dermatologists, Gynecologists, Endocrinologists and Family Physicians (FPs).
Methods: This cross-sectional study was done among 529 health care providers (HCPs) practicing in Mumbai metropolitan region using a convenient sample. A self-administered pretested questionnaire was filled by the HCPs after obtaining informed consent. Pearson’s Chi-square test and Analysis of Variance (ANOVA) was used to study the differences within each group.
Results: All HCPs reported that women with PCOS consulted them with a varied spectrum of symptoms. Among FPs, Allopaths had better knowledge about diagnosis and Homeopaths were more confident about PCOS management. Among Specialists, Endocrinologists were more stringent in diagnosing cases as per defined criteria, along with screening and comprehensive management of the metabolic syndrome. Although the need for multidisciplinary management was perceived, in practice holistic management was not common.
Conclusions: This study reveals the need for training and disseminating algorithms for comprehensive PCOS management across disciplines. It highlights women’s preferences in seeking health care for symptom complex of PCOS. These findings would help health policymakers to develop community-based awareness modules and India-specific management guidelines for early screening and a continuum of care for PCOS patients.
Authors
Beena Joshi
1,
Gazala Hasan
2,
Gulrez Tyebkhan
3,
Shobha Udipi
4,
Anushree Patil
5,
Duru Shah
6,
Madhuri Patil
7,
Roda Dalal
8,
Rama Vaidya
9
Affiliations
1 Scientist F, Department of Operational Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, IN
2 Senior Research Fellow, Department of Operational Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, IN
3 Hon Consultant Dermatologist, Medical Research Centre-Kasturba Health Society; Hon Dermatologist, Saifee Hospital, Mumbai, IN
4 Hon Director Integrative Nutrition and Ayurceuticals, Medical Research Centre-Kasturba Health Society, Mumbai, IN
5 Scientist D, Department of Clinical Research, ICMR- National Institute for Research in Reproductive Health, Mumbai, IN
6 President, PCOS Society, India. Scientific Director, Gynaecworld Assisted Fertility Center, Mumbai, IN
7 Vice-President, PCOS Society, India; Clinical Director, Dr. Patil’s Fertility and Endoscopy Clinic, Bengaluru, IN
8 Hon Editorial Consultant and Communications Associate, Medical Research Centre-Kasturba Health Society, Mumbai, IN
9 Director, Division of Endocrine and Metabolic Disorders, Medical Research Centre-Kasturba Health Society, Mumbai, IN
1 Scientist F, Department of Operational Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, IN
2 Senior Research Fellow, Department of Operational Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, IN
3 Hon Consultant Dermatologist, Medical Research Centre-Kasturba Health Society; Hon Dermatologist, Saifee Hospital, Mumbai, IN
4 Hon Director Integrative Nutrition and Ayurceuticals, Medical Research Centre-Kasturba Health Society, Mumbai, IN
5 Scientist D, Department of Clinical Research, ICMR- National Institute for Research in Reproductive Health, Mumbai, IN
6 President, PCOS Society, India. Scientific Director, Gynaecworld Assisted Fertility Center, Mumbai, IN
7 Vice-President, PCOS Society, India; Clinical Director, Dr. Patil’s Fertility and Endoscopy Clinic, Bengaluru, IN
8 Hon Editorial Consultant and Communications Associate, Medical Research Centre-Kasturba Health Society, Mumbai, IN
9 Director, Division of Endocrine and Metabolic Disorders, Medical Research Centre-Kasturba Health Society, Mumbai, IN
Source
The Indian Practitioner, Vol 74, No 7 (2021), Pagination: 15-22Abstract
Background: Polycystic Ovary Syndrome (PCOS) diagnosis is very complex and due to overlapping presentation of symptoms, women with PCOS may approach various practitioners, who might be using varied definitions to diagnose and manage PCOS.Objectives: To assess knowledge about PCOS diagnosis and management by Dermatologists, Gynecologists, Endocrinologists and Family Physicians (FPs).
Methods: This cross-sectional study was done among 529 health care providers (HCPs) practicing in Mumbai metropolitan region using a convenient sample. A self-administered pretested questionnaire was filled by the HCPs after obtaining informed consent. Pearson’s Chi-square test and Analysis of Variance (ANOVA) was used to study the differences within each group.
Results: All HCPs reported that women with PCOS consulted them with a varied spectrum of symptoms. Among FPs, Allopaths had better knowledge about diagnosis and Homeopaths were more confident about PCOS management. Among Specialists, Endocrinologists were more stringent in diagnosing cases as per defined criteria, along with screening and comprehensive management of the metabolic syndrome. Although the need for multidisciplinary management was perceived, in practice holistic management was not common.
Conclusions: This study reveals the need for training and disseminating algorithms for comprehensive PCOS management across disciplines. It highlights women’s preferences in seeking health care for symptom complex of PCOS. These findings would help health policymakers to develop community-based awareness modules and India-specific management guidelines for early screening and a continuum of care for PCOS patients.
Keywords
Polycystic ovary syndrome, healthcare providers, knowledge assessment, practice, managementReferences
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- Joshi B, Mukherjee S, Patil A, Purandare A, Chauhan S, Vaidya R. A cross-sectional study of polycystic ovarian syndrome among adolescent and young girls in Mumbai, India. Indian J Endocrinol Metab. 2014 May;18(3):317-24.
- Dokras A, Saini S, Gibson-Helm M, Schulkin J, Cooney L, Teede H. Gaps in knowledge among physicians regarding diagnostic criteria and management of polycystic ovary syndrome. Fertil Steril. 2017 Jun;107(6):1380-1386.e1. Epub 2017 May 5.
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- Lin AW, Bergomi EJ, Dollahite JS, Sobal J, Hoeger KM, Lujan ME. Trust in Physicians and Medical Experience Beliefs Differ Between Women With and Without Polycystic Ovary Syndrome. J Endocr Soc. 2018 Aug 1;2(9):1001-1009.
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- Hillman JK, Johnson LN, Limaye M, Feldman RA, Sammel M, Dokras A. Black women with polycystic ovary syndrome (PCOS) have increased risk for metabolic syndrome and cardiovascular disease compared with white women with PCOS [corrected]. Fertil Steril. 2014 Feb;101(2):530-5. Epub 2013 Dec 30. Erratum in: Fertil Steril. 2014 Jun;101(6):1791.
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- Goyal M, Dawood AS. Debates Regarding Lean Patients with Polycystic Ovary Syndrome: A Narrative Review. J Hum Reprod Sci. 2017 Jul-Sep;10(3):154-161.
- Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. International PCOS Network. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril. 2018 Aug;110(3):364-379. Epub 2018 Jul 19.
- Ding T, Baio G, Hardiman PJ, Petersen I, Sammon C. Diagnosis and management of polycystic ovary syndrome in the UK (2004-2014): a retrospective cohort study. BMJ Open. 2016 Jul 11;6(7): e012461
- Teede H, Gibson-Helm M, Norman RJ, Boyle J. Polycystic ovary syndrome: perceptions and attitudes of women and primary health care physicians on features of PCOS and renaming the syndrome. J Clin Endocrinol Metab. 2014 Jan;99(1): E107-11. Epub 2013 Dec 20.
- Lin AW, Bergomi EJ, Dollahite JS, Sobal J, Hoeger KM, Lujan ME. Trust in Physicians and Medical Experience Beliefs Differ Between Women With and Without Polycystic Ovary Syndrome. J Endocr Soc. 2018 Aug 1;2(9):1001-1009.
- ABHIYAAN PCOS, A Consortium for Multidisciplinary Strategy for Management
Abstract Views :100 |
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Authors
Affiliations
1 Hon Consultant Dermatologist, Medical Research Centre- Kasturba Health Society, Mumbai, India. Hon Dermatologist, Saifee Hospital, Mumbai, IN
2 Scientist F, Department of Operational Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, IN
3 Director, Division of Endocrine and Metabolic Disorders,Medical Research Centre- Kasturba Health Society, Mumbai, IN
1 Hon Consultant Dermatologist, Medical Research Centre- Kasturba Health Society, Mumbai, India. Hon Dermatologist, Saifee Hospital, Mumbai, IN
2 Scientist F, Department of Operational Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, IN
3 Director, Division of Endocrine and Metabolic Disorders,Medical Research Centre- Kasturba Health Society, Mumbai, IN
Source
The Indian Practitioner, Vol 74, No 7 (2021), Pagination: 41-45Abstract
Polycystic Ovary Syndrome (PCOS), a common reproductive-endocrine-metabolic disorder of women with its galloping prevalence is reaching epidemic proportions today in India and abroad. Women suffering from PCOS have a wide spectrum of clinical manifestations like irregular menstrual cycles, infertility, hirsutism, acne and vulnerability for obesity. Besides these women are at a risk for concurrently manifesting obesity and prediabetes or subsequent development of type 2 diabetes mellitus and consequent cardiovascular diseases. Some of the manifestations have caused stigmatization and social isolation of women with PCOS contributing to its adverse psycho-social impact. This multiplicity of diverse manifestations makes it difficult for the patients to choose a specialist. As a consequence, there is often a fragmented attention to PCOS from diverse specialties like dermatology, gynecology, diabetology and psychiatrist. Additionally, the less known and poorly understood etiology of PCOS have also posed a challenge for medical science for committed research, education and organized services. This is more so due to the compartmentalization and divergence into super specialization in modern medical and biomedical sciences. Recognizing PCOS as a condition of great public health issue in India, a group of committed clinical and basic scientists from four major institutes of Mumbai formed, ABHIYAAN PCOS, a consortium for a co-operative endeavor in addressing the multiple aspects that concern women with PCOS. In the present article, we have covered the ground reality of the PCOS in India, the need to develop India-specific guidelines in-view of the pluralistic healthcare and the current efforts in the domain of PCOS by both private and public health-sectors.References
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- Joshi B, Hasan G, Tyebkhan G, Udipi S, Patil A et al. Knowledge and Management practices about Polycystic Ovarian Syndrome among Health Care Providers in Mumbai, India: a cross-sectional study. The Indian Practitioner. 2021; 74:15-22.
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- Evidence-Based Cost-Effective Interventions for Universal Health Coverage
Abstract Views :65 |
PDF Views:1
Authors
Affiliations
1 Scientist F and Head, Department of Operational and Implementation Research, ICMR National Institute for Research in Reproductive and Child Health, Parel, Mumbai, IN
2 Project Scientist Health Technology Assessment Resource Hub, ICMR National Institute for Research in Reproductive and Child Health, Parel, Mumbai, IN
1 Scientist F and Head, Department of Operational and Implementation Research, ICMR National Institute for Research in Reproductive and Child Health, Parel, Mumbai, IN
2 Project Scientist Health Technology Assessment Resource Hub, ICMR National Institute for Research in Reproductive and Child Health, Parel, Mumbai, IN
Source
The Indian Practitioner, Vol 76, No 7 (2023), Pagination: 6-8Abstract
India has intensified efforts towards Universal Health Coverage. To achieve this goal, it is important to spend the resources on cost-effective healthcare interventions. Economic evaluations and Health Technology Assessments are important tools to ensure the efficient use of resources. India has made significant progress in this direction, especially with the establishment of Health Technology Assessment (HTA) - India. Further capacity-building and strengthening of HTA is required to ensure the implementation of evidence-based cost-effective interventions in the health sector.Keywords
Health Technology Assessment, Economic Evaluation, Cost-Effectiveness.References
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