title: Prevalence and detection rate of underlying disease in men with erectile dysfunction receiving phosphodiesterase type 5 inhibitors in the United Kingdom: a retrospective database study.
abstract: OBJECTIVE
  To determine the rate of newly detected underlying disease in men receiving their first (index) phosphodiesterase type 5 inhibitor (PDE5i) prescription.
  
  
  METHODS
  This non-interventional, retrospective study used anonymised patient records from UK general practices identified from the THIN database. Records of men aged ≥ 18 years, who received an index PDE5i prescription between January 1999 and June 2008 and with a continuous medical history (≥ 60 months) before the index prescription were included. Primary end-points were the prevalence of underlying disease prior to the index prescription and to establish the detection rate, defined as cumulative incidence of such a diagnosis in the 3 months following the index prescription. Assessments included comparison with age-matched controls, comparison with identical time periods immediately before and 1 year after, index prescription, and changes over time during the study period. Descriptive statistics, analysis of proportions and multivariate logistic regression analysis were used.
  
  
  RESULTS
  Among the 24,708 patients receiving a PDE5i, the prevalence of any underlying diagnosis before the index prescription was 70.23%; prevalence of vasculogenic disease was highest (48.20%). The detection rate of any underlying disease was 11.53%, and again highest for vasculogenic disease (4.07%). Compared with an age-matched control population, the additional detection rate of an unknown underlying disease at PDE5i prescription was 45 for hypertension, 61 for hypercholesterolaemia, 38 for diabetes and 5 for hypogonadism per 10,000 men.
  
  
  CONCLUSIONS
  Only a minority of men with erectile dysfunction have a previously undiagnosed important underlying disease that is uncovered at the time of an initial PDE5i prescription by a GP.
authors.affiliation: Faculty of Health and Human Sciences, Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK. kirbym@globalnet.co.uk
authors.forename: M G
authors.initials: MG
authors.lastname: Kirby
authors.forename: G
authors.initials: G
authors.lastname: Schnetzler
authors.forename: K H
authors.initials: KH
authors.lastname: Zou
authors.forename: T
authors.initials: T
authors.lastname: Symonds
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D048909:Diabetes Complications / Q000150:complications / Q000175:diagnosis; D042241:Early Diagnosis; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000175:diagnosis; D006973:Hypertension / Q000150:complications / Q000175:diagnosis; D007006:Hypogonadism / Q000150:complications / Q000175:diagnosis; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D058986:Phosphodiesterase 5 Inhibitors