Satisfaction and treatment adherence in erectile dysfunction in the medium and long term

Actas Urol Esp. 2017 May;41(4):258-266. doi: 10.1016/j.acuro.2016.09.011. Epub 2016 Nov 16.
[Article in En, Spanish]

Abstract

Introduction: The aim of this study was to show the satisfaction and treatment adherence in erectile dysfunction (ED) in the medium and long term.

Material and methods: A descriptive, comparative study was conducted in 2 centres through telephone interviews with patients who came for an initial visit between 2012 and 2014 for ED. A complete case history review was conducted on the use of and withdrawal from treatment. For current use, the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and the Global Assessment Questionnaire (GAQ) were filled out; for past use, only the GAQ was filled out. For the statistical analysis, we employed Fisher's exact test for comparisons of percentages and the Kruskal-Wallis test to compare means.

Results: The study included 250 patients; 20.8% were prescribed intraurethral alprostadil (ALP-IU), 17.2% were prescribed intracavernous alprostadil (ALP-IC), 92.8% were prescribed a first IPD5, and 24.8% were prescribed at least a second IPD5. The treatment withdrawal rate was 62.07% for the first IPD5, 41.94% for the last IPD5, 69.23% for the ALP-IU and 65.11% for the ALP-IC (P=.007). The main reason for withdrawal for the IPD5 was a lack of response (32.76% of those who took IPD5). In addition to withdrawal, there were adverse reactions for ALP-IU and ALP-IC (28.85% and 11.63%, respectively). The mean duration of use until withdrawal was 4.3 months for IPD5, 2.2 months for ALP-IU and 5.5 months for ALP-IC (P=.064). The most favourable GAQ and EDITS scores were observed for IPD5 (EDITS score of 74). Sildenafil and tadalafil had the longest usage times (mean >5 months).

Conclusions: The withdrawal rate for treating ED is high, with short usage times of a few months. A lack of response and adverse reactions were the main causes for withdrawal. The drugs that provide greater satisfaction are the IPD5, although there are no significant differences in the mean usage time between the different types and in aspects such as the mean usage time to withdrawal or the withdrawal rates.

Keywords: Alprostadil; Alprostadilo; Disfunción eréctil; Erectile dysfunction; Inhibidores-5-fosfodiesterasa; Phosphodiesterase-5 inhibitors; Tratamiento; Treatment.

Publication types

  • Comparative Study

MeSH terms

  • Alprostadil / therapeutic use*
  • Erectile Dysfunction / drug therapy*
  • Humans
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Patient Satisfaction*
  • Phosphodiesterase 5 Inhibitors / therapeutic use*
  • Self Report
  • Time Factors

Substances

  • Phosphodiesterase 5 Inhibitors
  • Alprostadil