title: Community pharmacy detection of erectile dysfunction in men with risk factors or who seek treatment or advice but lack a valid prescription.
abstract: BACKGROUND
  Pharmacists may be the first health care contact consulted about erectile dysfunction (ED).
  
  
  OBJECTIVE
  To assess pharmacists' ability to detect ED and encourage patients to seek medical evaluation.
  
  
  METHODS
  This observational study conducted in Greece and Spain included men without a valid prescription for an ED medication but with a history indicating ED risk and/or who consulted a pharmacist about ED. Pharmacists completed a questionnaire about the patient. Patients completed the Sexual Health Inventory for Men (SHIM); men with a score ≤21 (cutoff for ED) were educated (by case pharmacists) and referred and encouraged to see a physician (by case and control pharmacists).
  
  
  METHODS
  Proportion of men with a SHIM score ≤21 and, of those, the proportion who visited a physician and credited the pharmacist for their visit. ANCOVA and chi-square test were used for continuous and categorical data, respectively.
  
  
  RESULTS
  Among the 451 men (mean ± SD age, 54.9 ± 12.9 years) questioned about ED, 90% had a risk factor (usually hypertension, hypercholesterolemia, or diabetes), 28% had a previous diagnosis, 36% sought internet information, 38% self-medicated, 10% took medication obtained outside the pharmacy setting, and the first health care professional approached was a pharmacist (50%), physician (18%), or nurse (1%) at a median of 6 (range, 0-360) months after symptom onset. The SHIM score was ≤21 in 348 (77%) men. A lower score (indicating increased ED severity) was associated with increased age and with benign prostate hyperplasia, depression, diabetes, or prostate cancer. In the minority of men contacted for follow-up, less than one-third had visited their physician, despite pharmacist encouragement.
  
  
  CONCLUSIONS
  Pharmacists are often the first health care contact regarding ED and are highly accurate in its detection. Further research is needed to optimize the pharmacist's role in early detection, education, and motivating patients to be evaluated by a physician.
authors.affiliation: Carlos Haya University Hospital, Málaga, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Martin Morales
authors.forename: Dimitris
authors.initials: D
authors.lastname: Hatzichristou
authors.forename: Joan
authors.initials: J
authors.lastname: Ramon Lladós
authors.forename: Virginia
authors.initials: V
authors.lastname: Pascual Renedo
authors.forename: Apostolia
authors.initials: A
authors.lastname: Pimenidou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003157:Community Pharmacy Services; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D007172:Erectile Dysfunction / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D006115:Greece / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D010595:Pharmacists; D024382:Professional Role; D011369:Professional-Patient Relations; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Community Pharmacy Services; Erectile Dysfunction; Patient Education Handout; Patient Education as Topic; Phosphodiesterase Inhibitors; Prescription; Referral and Consultation; Sildenafil; Tadalafil; Vardenafil