title: Decision tree analyses of key patient characteristics in Middle Eastern/North African and Latin American men treated with long-acting and short-acting PDE5 inhibitors for erectile dysfunction.
abstract: BACKGROUND
  Phosphodiesterase type 5 (PDE5) inhibitors have discontinuation rates as high as 60% in men with erectile dysfunction. Treatment satisfaction has been significantly associated with treatment continuation. Understanding key characteristics in terms of treatment preference, relationship, and lifestyle issues could provide direction on how to improve compliance with PDE5 inhibitor treatment globally.
  
  
  OBJECTIVE
  The objective was to identify subgroups of interest in the pooled database of two observational studies conducted in Latin America (LA) and Middle East/North Africa (MENA) exploring patient characteristics and prescription of either a long- or short-acting PDE5 inhibitor at baseline.
  
  
  METHODS
  Two identical prospective, non-interventional, observational, studies in MENA (N = 493) and LA (N = 511) treated men with an 'on demand' (pro re nata, PRN) PDE5 inhibitor (sildenafil, tadalafil, vardenafil, or lodenafil) during 6 months. In this post-hoc meta-analysis of two observational studies with equal design, pooled data were analyzed to determine patient characteristics and PDE5 inhibitor prescribed/used most likely to be associated with patient expectations, satisfaction, self-esteem, and patient-partner relationships. Decision tree analyses, with and without weighting, were used to identify and describe key features.
  
  
  RESULTS
  In each analysis of patient expectations, patient-partner relationship, and self-esteem, we describe the two major subgroups at baseline for each decision tree. Analyses of patient expectations and sexual self-esteem revealed that patients prescribed long-acting PDE5 inhibitors (59%) highlighted the importance of treatment effect duration, second to partner satisfaction with treatment, while patients prescribed short-acting PDE5 inhibitors (32%) placed less importance on treatment effect duration but considerable importance on treatment effect lasting until intercourse completion. Further insights regarding patients, partner relationship characteristics, and treatment expectations were identified.
  
  
  CONCLUSIONS
  Our analyses have described key characteristics, such as self- and partner perceptions, sexual attitudes, and treatment expectations in relation to the patients' country and prescribed treatment, which might guide treatment decisions in MENA and LA men with ED.
authors: Asociación Mexicana para la Salud Sexual, AC (AMSSAC) , Mexico City , Mexico.
authors: Eusebio
authors: E
authors: Rubio-Aurioles
authors: Amr
authors: A
authors: El-Meliegy
authors: Samer
authors: S
authors: Abdulwahed
authors: Carsten
authors: C
authors: Henneges
authors: Sebastian
authors: S
authors: Sorsaburu
authors: Sirel
authors: S
authors: Gurbuz
mesh_terms: D000328:Adult; D000352:Africa, Northern / Q000453:epidemiology; D003663:Decision Trees; D003692:Delayed-Action Preparations / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use; D007172:Erectile Dysfunction / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D007843:Latin America / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D010349:Patient Compliance; D057240:Patient Preference; D058986:Phosphodiesterase 5 Inhibitors / Q000145:classification / Q000493:pharmacokinetics / Q000627:therapeutic use; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D012649:Self Concept; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D003692:Delayed-Action Preparations; D058986:Phosphodiesterase 5 Inhibitors
keywords: Decision tree analysis; Erectile dysfunction; Latin American; Middle Eastern/North African; PDE5 inhibitor; Tadalafil