title: Can an educational program optimize PDE5i therapy? A study of Canadian primary care practices.
abstract: BACKGROUND
  The importance of patient instructions, designed to optimize therapy with phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction (ED), has recently been demonstrated.
  
  
  OBJECTIVE
  To evaluate the impact of an educational program for new sildenafil users against usual ED management in Canadian primary care practices.
  
  
  METHODS
  This multicenter, 6-month cluster randomized prospective study was conducted across Canada in general practitioners' offices where sites were randomized to receive a treatment optimization program (TOP) tool at visit 1 (TOP sites) or not to receive the TOP tool (non-TOP sites) while continuing with usual practice. Study participants were men seeking medical attention for ED and who were sildenafil naïve. The TOP tool consisted of a tear-off sheet, a brochure, and a video. Study drug was not provided to the patients. Sildenafil samples and prescriptions were dispensed as per usual care practices.
  
  
  METHODS
  The Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire was used to determine treatment satisfaction at visit 2 (month 3) and visit 3 (month 6). Patient and physician satisfaction with the TOP tool was assessed using self-reported questionnaires.
  
  
  RESULTS
  The intent-to-treat (ITT) population consisted of 2,573 patients from 231 primary care sites. At visits 2 and 3, treatment satisfaction with sildenafil was high with almost 9 patients out of 10 satisfied with treatment. No significant statistical differences were observed in the EDITS scores between the TOP and the non-TOP groups at visits 2 and 3. More than 80% of the participants were satisfied or very satisfied with the video and the brochure. More than 8 out of 10 participating physicians (84%) would use the TOP tool in their current practice if available.
  
  
  CONCLUSIONS
  TOP is a valuable and time-efficient ED management tool providing benefits to newly diagnosed ED patients and to their physicians.
authors.affiliation: Department of Urology, St. Joseph's Healthcare, London, Ontario, Canada.
authors.forename: Gerald
authors.initials: G
authors.lastname: Brock
authors.forename: Serge
authors.initials: S
authors.lastname: Carrier
authors.forename: Richard
authors.initials: R
authors.lastname: Casey
authors.forename: Jean-Eric
authors.initials: JE
authors.lastname: Tarride
authors.forename: Stacey
authors.initials: S
authors.lastname: Elliott
authors.forename: Hélène
authors.initials: H
authors.lastname: Dugré
authors.forename: Catherine
authors.initials: C
authors.lastname: Rousseau
authors.forename: Pina
authors.initials: P
authors.lastname: D'Angelo
authors.forename: Isabelle
authors.initials: I
authors.lastname: Defoy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D003131:Combined Modality Therapy; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011320:Primary Health Care / Q000458:organization & administration*; D011369:Professional-Patient Relations; D011446:Prospective Studies; D011687:Purines / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate