title: Evaluation of erectile dysfunction therapy in patients previously nonadherent to long-term medications: a retrospective analysis of prescription claims.
abstract: Erectile dysfunction (ED) can lead to treatment noncompliance in patients taking medications for chronic health conditions. Using the Intelligent Health Repository, NDCHealth's longitudinal, United States health care claims database, we examined the impact of treating ED on adherence to long-term therapies in previously nonadherent patients. Male patients >or=18 years of age were identified who received antidepressant (AD), antihypertensive (AH), oral hypoglycemic (OHG), or lipid-lowering (LL) agents and initiated therapy with sildenafil citrate (Viagra) between January and June 2003. Treatment adherence was determined using medication possession ratios (MPRs) for the 12 months before and after the first prescription of sildenafil. Prior to initiation of therapy for ED with sildenafil, 64% of patients with comorbid medications were not adherent (MPR <0.8). Among these patients, 728 (27%) received AD, 2112 (78%) received AH, 984 (18%) received OHG, and 1078 (40%) received LL agents, with 66% of patients receiving multiple therapeutic classes. During the 12-month period after the first sildenafil prescription, patients had a significant increase in medication adherence compared with the 12 months before the first prescription of sildenafil (P < 0.0001). The percentage of patients who became adherent (MPR >or=0.8) with medications after sildenafil treatment was from 22% to 36%. With the exception of the LL group, there was a significant relationship between >or=3 sildenafil prescriptions and change in MPR (P < 0.05). Patients aged >or=65 years had similar improvement in MPR as patients <or=65 years. Treatment of ED with sildenafil improved adherence in patients taking common long-term medications who were previously nonadherent.
authors.affiliation: NDCHealth, Phoenix, AZ 85016, USA. McLaughlin@ndchealth.com
authors.forename: Trent
authors.initials: T
authors.lastname: McLaughlin
authors.forename: James
authors.initials: J
authors.lastname: Harnett
authors.forename: Soraya
authors.initials: S
authors.lastname: Burhani
authors.forename: Brian
authors.initials: B
authors.lastname: Scott
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000009:adverse effects; D002908:Chronic Disease / Q000188:drug therapy*; D015897:Comorbidity; D016208:Databases, Factual; D007172:Erectile Dysfunction / Q000139:chemically induced / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines; D012189:Retrospective Studies; D000068677:Sildenafil Citrate; D013450:Sulfones; D016312:Treatment Refusal
chemical_list: D000928:Antidepressive Agents; D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate