All current clinical recommendations for the condition remain the same.
The consensus group is working with international classification bodies for a planned 3-year transition period to a new PMOS ICD code.
That said, prior authorization requests and insurance documentation may note either PCOS or PMOS.
Start by updating your clinical vocabulary from PCOS to PMOS and encourage the same of your colleagues.
Educate patients and provider colleagues about the metabolic and endocrine components of the condition and the available off-label uses of medications for PMOS.
Following a thorough, multistep global consensus process, Professor Helena Teede, PhD, MBA, FRACP, an endocrinologist with Monash University in Australia, spearheaded an initiative to rename polycystic ovary syndrome (PCOS) to polyendocrine metabolic ovarian syndrome (PMOS).1 This change was a long time coming.
For years, medical experts argued that PCOS was a misnomer, contributing to confusion and, ultimately, underdiagnosis.1,2 Despite what the PCOS name suggested, polycystic ovarian morphology is neither required nor sufficient alone for diagnosis.3 Furthermore, the ovarian “cysts” of PCOS were not cysts at all but rather growth-arrested follicles.1,4
These misconceptions contributed to delayed diagnoses, with up to 70% of affected people remaining undiagnosed, and poor patient satisfaction.1 PCOS implied a purely gynecologic condition that ignored the disorder’s endocrine, cardiovascular, and metabolic pathophysiologic dysfunction entirely.
Conversely, PMOS encapsulates its multisystem dysfunction, including its polyendocrine features (hyperandrogenism, gonadotropin dysregulation), metabolic features (obesity, insulin resistance, type 2 diabetes, dyslipidemia, cardiovascular disease, metabolic dysfunction-associated steatotic liver disease, sleep apnea), and ovarian features (ovulatory disturbances, irregular menstrual cycles, infertility, pregnancy complications, endometrial cancer, follicular arrest).1
In theory, this name change will have positive impact for patients as better understanding of the condition expands throughout the medical community. But what are the practical implications for pharmacists?
An implementation strategy is underway with a focus on evolution rather than disruptive transformation.1 During this transitional period, consider the following1,5-7:
The diagnostic criteria for the syndrome remain the same. Patient still need 2 of the 3 following for diagnosis: hyperandrogenism, oligo-anovulation (ovulatory dysfunction), polycystic ovaries on ultrasound, or elevated Anti-Müllerian hormone.
All current clinical recommendations for the condition remain the same. As of now, pharmacotherapy for PMOS is entirely off-label and treatment selection is determined by primary symptoms, patient preferences, and reproductive goals (Table 1).
The current International Classification of Diseases (ICD) code for billing and claims processing remains the same for now. The consensus group is working with international classification bodies for a planned 3-year transition period to a new PMOS ICD code. However, until coding systems update, expect prescriptions, prior authorizations, and insurance documents to continue referencing PCOS/E28.2 (ICD-10) or PCOS/5A80.1 (ICD-11).
Drug labeling and workflows at the pharmacy remain the same. That said, prior authorization requests and insurance documentation may note either PCOS or PMOS. Understand they are the same condition.
During this transition period, pharmacists likely will play the biggest role in educating others. Start by updating your clinical vocabulary from PCOS to PMOS and encourage the same of your colleagues. Proactively address the name change with patients to mitigate confusion. Advocate for appropriate cardiometabolic screening and evidence-based management. Educate patients and provider colleagues about the metabolic and endocrine components of the condition and the available off-label uses of medications for PMOS.
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