Challenges experienced by those with polycystic ovary syndrome in healthcare interactions: a qualitative evidence synthesis

Studies report interaction difficulties between patients with polycystic ovary syndrome (PCOS) and healthcare professionals. This systematic review and qualitative evidence synthesis aimed to collate and synthesise the existing peer reviewed literature investigating challenges for people with PCOS when interacting with healthcare professionals (HCPs). Medline, PsycInfo, EMBASE, All EBM, and CINAHL were searched from inception to September 2022. Study risk of bias (RoB) was performed and all textual data relevant to challenging interactions between patients with PCOS and HCPs were extracted and analysed using thematic synthesis. Of the 6353 studies identified, 28 were included. Six were appraised high, four as moderate and 22 as low RoB. Four analytic themes were derived illustrating interactions were challenging when: (1) medical information (PCOS, its management) was not shared in the best way; (2) information provision and deliberation opportunities were insufficient to achieve outcomes that mattered to patients; (3) they prompt but do not support patient activation; and (4) health system level barriers (e.g., policies, guidelines) were present or made worse by HCP behaviour. Future research should examine methods for the implementation and evaluation of established frameworks for sharing medical information and supporting patient agency in the context of PCOS care.