Interdisciplinary Implementation of the International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (PCOS): Care Gaps and Knowledge Deficits in Key High-Burden Domains

Objectives Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age and is associated with significant metabolic, reproductive, and psychological morbidity. Although international evidence-based guidelines exist, patient reports continue to indicate unmet needs, particularly in areas that most affect quality of life. The primary objective of this study was to assess PCOS-related knowledge, as well as general practitioners` (GPs) perceptions and interdisciplinary communication practices. A secondary objective was to examine whether identified knowledge gaps among GPs align with symptom domains reported by patients as most bothersome. Design This study employed a cross-sectional survey design targeting practicing GPs. Quantitative findings were descriptively analyzed and contextualized using published data from an independent, large-scale patient survey. Participants/Materials A total of 918 GPs practicing in the federal state of Hesse, Germany, were invited to participate. The final analytical sample comprised 118 GPs who completed the survey. The GP questionnaire included demographic and professional characteristics as well as a 21-item knowledge assessment derived from the 2018 international PCOS guideline. To contextualize GP findings, data from a published patient survey including 1,926 individuals with PCOS were used to identify patient-prioritized symptom domains. Setting The study was conducted in primary care settings across Hesse, Germany. Methods The GP survey assessed awareness of PCOS prevalence, familiarity with guideline recommendations, perceived relevance of guidelines to daily practice, and interdisciplinary collaboration, particularly with gynecologists. Knowledge accuracy scores were calculated as the percentage of correct responses across the 21 items. Subgroup analyses explored associations between GP characteristics and knowledge levels. Published patient survey data were used to determine symptom burden and domains perceived as most distressing, allowing comparison with GP knowledge gaps. Results 93.2% of GPs estimated a PCOS prevalence in their practice below 5% and 69.5% considered the international PCOS guideline irrelevant to routine practice. PCOS-related knowledge among participants showed a mean accuracy of 54.6% (95% CI 50.4-58.8) across all domains, with the lowest scores in reproductive aspects, (45.5%, 95% CI 40.6-50.4) and hyperandrogenism (43.7%, 95% CI 38.7-48.7). Notably, cosmetic manifestations of hyperandrogenism were identified by patients as among the most burdensome symptoms. Furthermore, 45.8% of GPs reported suboptimal communication with gynecologists, highlighting deficiencies in interdisciplinary care pathways. Limitations Limitations include a low response rate with potential nonresponse bias, the newly developed questionnaire without formal psychometric validation and reliance on self-reported data. In addition, variation in patient populations across practices and the lack of linkage between physician responses and patient outcomes may limit generalizability. Conclusions PCOS-related knowledge gaps among GPs are most pronounced in clinical domains that patients perceive as most distressing, highlighting a critical mismatch between care provision and patient needs. These findings underscore the necessity for targeted educational interventions, improved dissemination and implementation of PCOS guidelines in primary care, and strengthened interdisciplinary collaboration to enhance patient-centered PCOS management.