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Care for Adolescents With Polycystic Ovary Syndrome: Development and Prescribing Patterns of a Multidisciplinary Clinic
- Source :
- Journal of Pediatric and Adolescent Gynecology. 34:617-625
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Study Objective: Based on updated guidelines and expressed patient needs, we created a multidisciplinary clinic including endocrinology, gynecology/adolescent medicine, dermatology, psychology, and nutrition to provide comprehensive care to adolescent girls with polycystic ovary syndrome (PCOS). We describe the patient population presenting to this clinic, and prescribing patterns when a multidisciplinary approach is used. Design: Retrospective chart review. Setting: Tertiary care hospital. Participants: Female patients, aged 11-24 years, presenting for initial assessment in a multidisciplinary PCOS clinic. Interventions: None. Main Outcome Measures: Medical history, physical examination findings, laboratory measurements and prescribed therapies. Results: A total of 92 patients seen from 2014 to 2018 are described (age 15.9 years, range 11-24 years, body mass index 35.6 kg/m2, range 19.9-53.5). Metabolic syndrome features were common: 26% had a prediabetes hemoglobin A1c (>5.6%), 83% had a high-density lipoprotein (HDL) 120 mm Hg, and 43% had an alanine aminotransferase level of >30 U/L. Dermatologic findings included acne 93%, hirsutism 38%, acanthosis nigricans 85%, hidradenitis suppurativa 16%, and androgenic alopecia 2%. Of the patients, 33% had a diagnosis of depression or anxiety, 16% of patients had a diagnosis of obstructive sleep apnea, and an additional 59% had symptoms warranting a sleep study The most commonly prescribed medications were topical acne preparations (62%), followed by estrogen-containing hormonal therapy (56%) and metformin (40%). Conclusion: In adolescents with PCOS and obesity, metabolic, dermatologic, and psychologic co-morbidities are common. The use of a multidisciplinary clinic model including dermatology in addition to endocrinology, gynecology, psychology, and lifestyle experts provides care for most aspects of PCOS.
- Subjects :
- medicine.medical_specialty
Pediatrics
030219 obstetrics & reproductive medicine
medicine.diagnostic_test
business.industry
Obstetrics and Gynecology
Physical examination
General Medicine
medicine.disease
Polycystic ovary
03 medical and health sciences
Adolescent medicine
0302 clinical medicine
Pediatrics, Perinatology and Child Health
medicine
Hidradenitis suppurativa
Medical history
030212 general & internal medicine
Sleep study
business
hirsutism
Depression (differential diagnoses)
Subjects
Details
- ISSN :
- 10833188
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric and Adolescent Gynecology
- Accession number :
- edsair.doi...........08526bfbd8d1d116690373c96f9d857a