OBJECTIVES : The objective of this study is to systematically review the literature on adherence to treatments for PCOS.

METHODS : A systematic search of Embase, Cochrane, PubMed, CINAHL, PsychINFO, SOPUS, and International Pharmaceutical Abstracts was conducted from inception until January 2019 utilizing the terms PCOS, adherence, and patient compliance. In total 179 possible articles were identified and were screened for full-text review. Inclusion criteria followed focus on PCOS and focus on adherence or compliance to a therapy or treatment regimen. A total of 34 articles were identified for full-text review and 19 of these articles were excluded. Study quality assessment was conducted using the PEDro scale items. To identify themes, an Inductive Content Analysis was conducted.

RESULTS : Fifteen articles reporting adherence data were included in the review. Six studies reported adherence to lifestyle interventions, such as prescribed diets and physical activity, and seven reported adherence to medications. Adherence rates ranged from 21.7% to 86%, with variations likely drive by factors such as length of follow-up, treatment type, and adherence measurement method. Only two medications were studied, metformin and oral contraceptives (OCP) and four themes were identified using ICA: limitations of reported adherence data, adherence to lifestyle interventions, adherence to medication interventions, and outcomes assessed concomitantly with adherence.

CONCLUSIONS : Diverse methods of adherence assessment are utilized. Adequate adherence data related to PCOS can be crucial for healthcare professionals as they seek to provide the highest quality of care to their patients. Pharmacists specifically can play an integral part in improving patient adherence for those with PCOS having complicated treatment plans. Future studies of PCOS treatments should effectively include and report at least one measure of adherence to every treatment evaluated. It is essential to make clinicians aware of treatment adherence as a significant factor in clinical outcomes for PCOS patients.