The impact of multidisciplinary care on attrition rates in weight management programs for women with polycystic ovary syndrome: a scoping review

Background: Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine system disorders affecting reproductive-aged women of all races and ethnicities. A high prevalence of obesity exists in women with PCOS, who are also vulnerable to attrition from weight management programs. Despite recommendations the implementation of multidisciplinary approaches in weight management programs, there is a lack of literature evaluating their usage in their treatment programs. Objectives: The objectives of this scoping review are to critically examine existing empirical literature to describe multidisciplinary approaches to weight management in populations diagnosed with PCOS and to identify potential factors associated with attrition. Eligibility criteria: This review includes prospective studies of individuals aged 15 and older diagnosed with PCOS enrolled in a multidisciplinary weight management program. Multidisciplinary interventions were defined as participants receiving two or more multidisciplinary lifestyle interventions. Sources of evidence: A systematic search of five electronic databases (MEDLINE, Cochrane, Embase, Cumulative Index to Nursing and Allied Health Literature, and Web of Science) identified articles with a multidisciplinary approach and reported data on attrition in PCOS weight management programs. Charting methods: A descriptive analytical approach and narrative synthesis was conducted to identify themes related to intervention delivery, attrition, and facilitators/barriers of PCOS lifestyle interventions. Results: From a total of 10,944 unique results, 11 articles met inclusion criteria for this review. Attrition rates ranged from 0% to 79.2%. Longer interventions were associated with higher rates of attrition. Control groups generally had lower attrition rates than their corresponding intervention groups. Studies incorporating technology-based interventions reported greater weight loss among participants. Conclusion: Attrition is inconsistently reported among PCOS weight management studies. Variation in attrition rates is likely influenced by several factors such as intervention length and intensity, identified facilitators and barriers to PCOS weight management, and the extent to which care plans are individualized.