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Advisor(s)
Abstract(s)
Phosphodiesterase type 5 inhibitors (PDE5) are currently the first line treatment for erectile dysfunction
(ED). However, previous research shows that PDE5 treatments have high discontinuation rates. Understanding
the reasons for discontinuing PDE5 will be necessary to optimize the response to treatment.
Aim. The main goals were: (i) to analyze discontinuation rate of PDE5; (ii) to identify the discontinuation
predictors; and (iii) to study the reasons for discontinuation using a qualitative methodology.
Main Outcome Measures. The PDE5 discontinuation rates, predictors, and reasons for discontinuation treatment.
Methods. A total of 327 men with clinical diagnosis for ED who had been treated with PDE5 were successfully
interviewed by telephone, after giving their informed consent by snail mail. Telephone interviews, concerning their
ongoing treatment, were carried out using a standardized questionnaire form with quantitative and qualitative items.
Participation rate was 71.8%.
Results. Of the total sample, 160 men (48.9%) had discontinued PDE5 treatment. The discontinuation rate was
higher among men with diabetes (73%) and in iatrogenic group (65%), and lower in venogenic etiology (38.7%).We
differentiated three groups of men who discontinued treatment (i) during the first 3 months (55.1%); (ii) between 4
and 12 months (26.9%); and (iii) after a period of 12 months (18%). Qualitative analyses revealed diverse reasons for
discontinuation: non-effectiveness of PDE5 (36.8%), psychological factors (e.g., anxiety, negative emotions, fears,
concerns, dysfunctional beliefs) (17.5%), erection recovery (14.4%), and concerns about the cardiovascular safety of
PDE5 (8.7%) were the most common. Older men and men whose partners were involved in the treatment, were less
likely to discontinue treatment.
Conclusion. Half the subjects discontinued medication. Mostly, there was a combination of factors that led to
discontinuation: non-effectiveness and psychosocial factors appear to be the main reasons. Addressing those factors
will allow following up with appropriate focus on relevant topics in order to improve compliance.
Description
Keywords
Erectile dysfunction PDE5 Dropout Vardenalfil Sildenafil Tadalafil
Citation
Journal of Sexual Medicine, 9, 2361-2369