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Med Sci (Basel). 2019 Jun 27;7(7). pii: E76. doi: 10.3390/medsci7070076.

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

Author information

1
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria 3168, Australia. lcbla2@student.monash.edu.
2
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria 3168, Australia. ichh1@student.monash.edu.
3
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria 3168, Australia. Nigel.Stepto@vu.edu.au.
4
Institute for Health and Sport, Victoria University, Melbourne, Victoria 8001, Australia. Nigel.Stepto@vu.edu.au.
5
Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, St. Albans, Victoria 3021, Australia. Nigel.Stepto@vu.edu.au.
6
Medicine- Western Health, Faculty of Medicine, Dentistry and Health Science, Melbourne University, Melbourne, Victoria 3000, Australia. Nigel.Stepto@vu.edu.au.
7
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria 3168, Australia. siew.lim1@monash.edu.

Abstract

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.

KEYWORDS:

behaviour change; exercise and physical activity; healthcare professionals and systems; models of care; weight management

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