Management of erectile dysfunction in general practice.
BACKGROUND
In recent years, the availability of effective oral pharmacological treatment for erectile dysfunction (ED) has revolutionized its management; however, it is still unclear how everyday clinical practice has changed in response to this evolving scenario.


OBJECTIVE
The aim of this study is to describe general practitioners' (GPs) beliefs and attitudes toward the management of ED.


METHODS
Each GP was asked to recruit consecutive men aged >or=18 years and sexually active, with already known erectile problems or with newly diagnosed ED.


METHODS
A written questionnaire was used to investigate GPs' sociodemographic characteristics and their beliefs toward the management of ED.


RESULTS
Overall, 127 GPs (53.4%) returned the questionnaire and 124 enrolled patients for the study. Only 9.5% of the GPs reported routinely inquiring about ED of patients >40 years of age, whereas 45.7% did it only when the patient raised the problem. GPs' gender and age were associated with their beliefs about ED treatment and referral to specialist care. Overall, 932 patients were enrolled, of whom 38% had newly diagnosed ED. The problem came to light for initiative of patient in 80% of cases, and 84.8% of men were prescribed a treatment. Patients who on their own initiative discussed of their condition had an almost 3-fold increased probability to be treated than those whose GP began the discussion about ED (odds ratio [OR] = 2.6, confidence interval [CI] 95% 1.5-4.5). Patients followed by female physicians were significantly more likely to be referred to a specialist than those followed by male physicians (OR = 3.3, CI 95% 1.4-5.0).


CONCLUSIONS
The management of ED has become an integral component of clinical practice in primary care. Nevertheless, barriers in addressing sexual issues still persist. Appropriate training is needed for a proactive approach to ED screening and management in men over 40s.
De Berardis
Giorgia
G
Consorzio Mario Negri Sud, Department of Clinical Pharmacology and Epidemiology, Santa Maria Imbaro, Italy.
Pellegrini
Fabio
F
Consorzio Mario Negri Sud, Department of Clinical Pharmacology and Epidemiology, Santa Maria Imbaro, Italy.
Franciosi
Monica
M
Consorzio Mario Negri Sud, Department of Clinical Pharmacology and Epidemiology, Santa Maria Imbaro, Italy.
Pamparana
Franco
F
Bayer Schering, Pharma Medical Division, Milan, Italy.
Morelli
Patrizia
P
Bayer Schering, Pharma Medical Division, Milan, Italy.
Tognoni
Gianni
G
Consorzio Mario Negri Sud, Department of Clinical Pharmacology and Epidemiology, Santa Maria Imbaro, Italy.
Nicolucci
Antonio
A
Consorzio Mario Negri Sud, Department of Clinical Pharmacology and Epidemiology, Santa Maria Imbaro, Italy;. Electronic address: nicolucci@negrisud.it.
D001291:Attitude of Health Personnel; D002243:Carbolines / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D010817:Physician-Patient Relations; D010879:Piperazines / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011320:Primary Health Care; D011687:Purines / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D000068581:Tadalafil; D014227:Triazines / Q000627:therapeutic use; D000069058:Vardenafil Dihydrochloride
D002243:Carbolines; D007093:Imidazoles; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014227:Triazines; D000069058:Vardenafil Dihydrochloride; D000068581:Tadalafil; D000068677:Sildenafil Citrate