Clinical audit on the long-term management of women with Polycystic Ovarian Syndrome in an urban GP surgery

Abstract

Background: Polycystic ovarian syndrome (PCOS) was historically largely under-recognised, underdiagnosed, and undermanaged. It is now considered one of the most common endocrine conditions affecting women of reproductive age. The long-term implications of PCOS include increased risk of developing diabetes, metabolic syndrome, and cardiovascular disease (CVD) risk factors. As such, national and international guidelines recommend that women with PCOS should be offered routine screening for diabetes and CVD risk factors. Objectives: To compare a GP surgery’s performance against national and international guidelines and recommendations with intent to improve the long-term management of women with PCOS, specifically with relevance to diabetes and CVD screening. Methods: This retrospective clinical audit assessed whether screening for HbA1c and/or oral glucose tolerance test (OGTT), body mass index (BMI), and blood pressure (BP) measurements were taken in women with PCOS at an urban GP surgery and compared these outcomes against national and international guideline standards. Results: 67 patients with PCOS were included in analysis. The GP surgery did not meet the 100% standard for all audited criteria. HbA1c/OGTT had been recorded in 67% of women over the age of 40 (n=21) within the past year and in 67% of women aged 40 or younger (n=46) within the past three years. BMI had been recorded in 54% of women within the past year. BP had been recorded in clinic in 37% of women within the past year. Conclusion: Although monitoring for signs of diabetes in patients with PCOS was present for two-thirds of patients, increased early detection and management of cardiovascular risk factors would greatly benefit this patient population. Raising awareness, improving sources of support, and self-advocacy are among future directions following this audit. Re-audit is planned after 12 months, to determine the extent of implementation of proposed changes in line with audited standards.