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Vol. 41. Issue 4.
Pages 258-266 (May 2017)
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Vol. 41. Issue 4.
Pages 258-266 (May 2017)
Original article
DOI: 10.1016/j.acuroe.2017.03.005
Satisfaction and treatment adherence in erectile dysfunction in the medium and long term
Satisfacción y adherencia al tratamiento en disfunción eréctil a medio y largo plazo
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J. Panach-Navarretea,
Corresponding author
jorpanav22@gmail.com

Corresponding author.
, A. Morales-Giraldoa, C. Ferrandis-Cortésb, F. García-Morataa, J.C. Pastor-Lenceb, J.M. Martínez-Jabaloyasa
a Servicio de Urología, Hospital Clínico Universitario de Valencia, Universitat de València, Valencia, Spain
b Servicio de Urología, Hospital Universitario de La Ribera, Alzira, Valencia, Spain
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Figures (1)
Tables (11)
Table 1. Baseline characteristics of the sample.
Table 2. Degree of completion with respect to the total prescriptions of each drug.
Table 3. Reason for non-use with respect to the total prescriptions of each drug. Descriptive analysis.
Table 4. Percentage of dropout on the total prescriptions and reason for dropout in each drug.
Table 5. Mean of use (in months) until dropout of each drug.
Table 6. Responses to the GAQ and EDITS questionnaires in each treatment group.
Table 7. Degree of completion with respect to the total prescriptions of each IPD5.
Table 8. Reason for non-use with respect to the total of prescriptions of each IPD5. Descriptive analysis.
Table 9. Percentage of dropout on the total of prescriptions and reason for dropout in each IPD5.
Table 10. Mean of use (in months) until dropout of each IPD5.
Table 11. Responses to the GAQ and EDITS questionnaires in each IPD5 group.
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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=0.007). 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=0.064). 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:
Erectile dysfunction
Treatment
Phosphodiesterase-5 inhibitors
Alprostadil
Resumen
Introducción

El objetivo ha sido mostrar la satisfacción y adherencia al tratamiento en disfunción eréctil (DE) a medio y largo plazo.

Material y métodos

Estudio descriptivo y comparativo llevado a cabo en 2 centros mediante entrevistas telefónicas a pacientes que realizaron una primera visita entre 2012 y 2014 por DE.

Se realizó una anamnesis completa sobre el uso y abandono del tratamiento. En caso de uso actual se cumplimentaron los cuestionarios EDITS y GAQ, y en caso de uso pasado solo el GAQ.

Para el análisis estadístico se utilizaron el test exacto de Fisher para las comparaciones de porcentajes y el test de Kruskal-Wallis para comparar medias.

Resultados

Doscientos cincuenta pacientes incluidos, habiendo recetado a un 20,8% alprostadilo intrauretral (AL-IU), a un 17,2% alprostadilo intracavenoso (AL-IC), a un 92,8% un primer IPD5, y a un 24,8% al menos un segundo IPD5.

El abandono del tratamiento fue del 62,07% en el primer IPD5 utilizado, del 41,94% en el último IPD5 probado, del 69,23% en el AL-IU y del 65,11% en el AL-IC (p=0,007). La principal razón de abandono en los IPD5 fue la falta de respuesta (32,76% de individuos que los toman). En el caso del AL-IU y AL-IC, además de esta destacan las reacciones adversas (28,85% y 11,63% respectivamente). La media de utilización hasta el abandono fue de 4,3 meses en IPD5, 2,2 meses en AL-IU y 5,5 meses en AL-IC (p=0,064). Las puntaciones del GAQ y EDITS más favorables se observaron en los IPD5 (EDITS de 74). Sildenafilo y tadalafilo tienen los tiempos más largos de uso (media mayor de 5 meses).

Conclusiones

El porcentaje de abandono en el tratamiento de la DE es alto, con tiempos cortos de uso de pocos meses, siendo las principales causas de abandono la falta de respuesta y las reacciones adversas. Los fármacos que aportan mayor satisfacción son los IPD5, sin existir diferencias significativas en el tiempo medio de uso entre los diferentes tipos y en aspectos como la media de uso hasta el abandono o los porcentajes de abandono.

Palabras clave:
Disfunción eréctil
Tratamiento
Inhibidores-5-fosfodiesterasa
Alprostadilo

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