The role of general practitioners in the management of erectile dysfunction—a qualitative study (original) (raw)
Related papers
Management of Erectile Dysfunction in General Practice
Journal of Sexual Medicine, 2009
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. Aim. 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 Ն18 years and sexually active, with already known erectile problems or with newly diagnosed ED.
Management of erectile dysfunction: perceptions and practices of Nigerian primary care clinicians
South African Family Practice, 2007
Background Erectile dysfunction (ED) is a prevalent health problem in many societies, but the diagnosis is seldom documented in primary care. The objective of this study was to investigate the perception and practices of clinicians regarding the management of ED in primary care settings in Nigeria. Methods A self-administered semi-structured questionnaire was applied to a purposive sample of clinicians attending conferences/ workshops organised by the Society of Family Physicians of Nigeria and Update Courses of the Faculties of Family Medicine of the National Postgraduate Medical College of Nigeria and the West African College of Physicians. Information was obtained on their professional characteristics, experiences with the management of ED and possible barriers to the effective management of ED. Results A total of 187 completed questionnaires were analysed. Most (87.2%) of the respondents were general practitioners, while the rest were specialists in various fields (excluding sexual health) who worked at the primary care level. One hundred and forty-seven respondents (76%) reported that ED was common in their clinical practice. Over half (56.2%) of the respondents ascribed a high priority to ED management in their day-today clinical practice, while 33.2% and 10.6% of them ascribed medium and low priority to ED management respectively. Although 80.8% of the respondents agreed that ED patients could benefit from orthodox treatments, only 18% of them had ever prescribed any medication for affected patients; most (82%) of them either counselled or referred ED patients to secondary or tertiary care level for further management. Most of the clinicians (62%) would not take a sexual history unless the patient brought it up. The reported barriers to the management of ED include lack of a standardised protocol (64.2%), inadequate experience in ED management (85.6%), preference of patients for native medication (42.3%), and the high cost of modern medication (48.1%). Conclusion The clinicians acknowledged the high prevalence of ED in the primary care setting and recognised that they had a role to play in managing affected patients. The identified barriers to the management of the condition point to the need for education of both clinicians and patients, as well as the provision of guidelines for the management of ED in primary care settings.
GPs' View on Barriers to Patients with Erectile Dysfunction: A Bulgarian Cross-sectional Study
Proceedings of the Bulgarian Academy of Sciences
Epidemiological studies show that erectile dysfunction (ED) is widespread worldwide and its prevalence tends to increase. ED influences quality of life, preceding or accompanying different diseases and it is a proven risk factor for cardiovascular disease. Different factors were found impeding patients to discuss the ED problem during the consultations. The aim of the study is to identify GPs’ view on barriers to patients with ED. A cross-sectional study, using questionnaire, was conducted among randomly selected GPs. For the statistical analysis descriptive statistics, chisquared test, Fisher’s exact test and SPSS 17.0 were used. The sample is nationally representative. Only 3% of all participants believe that patients share ED-related problems easily. The following most common barriers for the patients were identified by GPs: Inappropriate conditions – lack of privacy and lack of time in the doctor’s office (62.8%); embarrassment (60.2%), and the patient expects the erectile probl...
Integrating erectile dysfunction treatment into primary care practice
The American Journal of Medicine, 2000
Erectile dysfunction (ED) is a highly prevalent medical disorder. Nearly 1 of 3 men in the United States between the ages of 18 and 59 years report dissatisfaction with some aspect of their sexual function. These problems contribute to anxiety, depression, loss of self-esteem, and diminished quality of life. The availability of sildenafil, the first safe and effective oral agent for ED, has greatly increased the number of men seeking treatment and shifted much of the management of ED to primary care physicians. As a result, primary care physicians now need to add questions about sexual functioning and satisfaction with sex to their initial patient workups. Patients with ED can be treated by the primary care physician or referred to mental health professionals, endocrinologists, urologists, or sex therapists, depending on the problem presented. First-line treatments that can be easily prescribed and recommended by primary care clinicians include sildenafil, counseling, lifestyle changes, medication changes, and vacuum-constriction devices. The responsibilities of treating patients with ED include educating the patient about sexually transmitted diseases, providing general sex education and counseling to the patient and his partner, and providing a treatment that is appropriate for the cause of the problem. The rewards of treatment will be a happier and more functional patient, an enhanced physician-patient relationship, and great professional satisfaction.
Erectile Dysfunction in Brazilian Primary Health Care: Dealing with Medicalization
American journal of men's health, 2017
Erectile dysfunction (ED) is a common sexual problem and has been attracting growing interest from the field of medicine. The pharmaceutical industry works together with medical associations to popularize the theme, emphasizing individual enhancement and medication, besides reinforcing an idea of a male sexuality defined by the ability to have an erection and penetrate. Patients worried about erection problems search for general practitioners (GPs), frequently without a clear complaint, and a comprehensive primary health care (PHC) must be capable of dealing with these issues considering medicalization and disease mongering. This article discusses how PHC physicians take (and might take) care of men with erection problems, and how users perceive it and search for help in two cities in the State of São Paulo, Brazil. The qualitative research, performed in five PHC services, included semistructured interviews with 16 GPs and 15 adult male users. The adult male users were invited by th...
Knowledge International Journal, 2018
Introduction: Several factors play the role of barriers to GP-s and most of them avoid discussing the erectile dysfunction (ED) problem with their patients, even though a part of the patients hope the doctor would initiate such a discussion. Taking into account the relationship of ED with a number of socially significant diseases, these barriers impede the diagnostic process. Objective: To identify possible barriers to Bulgarian primary care physicians to address and discuss the ED problem with their patients. Materials and methods: The opinions of 12 GP-s from the town of Plovdiv, randomly selected, were studied using qualitative research methods, interview with standard open-ended questions, asked by the research investigator. An audio recording was made and transcribed by the interviewer and by two other research investigators. The obtained data are the result of a consensus. Results: Even though the majority of participants point out that doctors do not avoid and should not avoi...
Physicians' knowledge, attitude and practice towards erectile dysfunction in Saudi Arabia
Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ṣiḥḥīyah li-sharq al-mutawassiṭ
We aimed to test the knowledge, attitude and practice (KAP) of physicians towards erectile dysfunction in the Eastern province of Saudi Arabia. At a scientific meeting about erectile dysfunction, 159 physicians from both government and private sectors answered a 34-item questionnaire in private. The mean total KAP score for the group was below the expected standard of 60%. Male physicians scored significantly higher than females. Urologists scored the highest, followed by andrologists. Surprisingly, physicians with higher qualifications scored lower than those with intermediate qualifications and even less than general practitioners. Those who had practised for > or = 10 years scored better than those with < 10 years practice. The role of cardiologists in the diagnosis and management of erectile dysfunction is discussed.
Urology, 2001
Objectives. To examine the philosophies and practices of the family practitioner (FP) regarding the diagnosis and treatment of erectile dysfunction (ED). Methods. A prospective study by questionnaire of a group of FPs was performed. The Spearman correlation coefficient and proportional odds regression analysis were used to measure the relationship between the continuous variable and ordinal-scale variables. The Goodman-Kruskal gamma test was used to measure the strength of the association between the ordinal-scale variables.
Help seeking behaviour among men with erectile dysfunction in primary care setting
2011
To examine the self-reported erectile problem and help-seeking behaviour among men. Methods: A cross-sectional study was carried out among 1331 men aged 40 years and above who attended public primary care clinics in an urban district in Malaysia. Questions were asked regarding presence of erectile problem, help-seeking behaviour and treatment sought. Results: The mean age was 54.7 (±8.3), ranging from 40 to 79 years. Among the subjects, 69.5% (n = 925) had erectile dysfunction (ED); however, only 54.8% reported having difficulty with erection. The subjects with severe ED had higher proportion of self-reported ED (90.8%) than moderate (75.7%) and mild ED (27.4%). More than two-third of the subjects (67.2%) have spoken to someone about their difficulty; of these, 54.1% spoke to their spouse or partner, 6.3% to friends and 5.3% to family members. Only 32.4% had initiated the discussion with their doctor, whereas only 10.5% reported that their doctor had raised the issue. Among the men who did not seek any help, reasons were: ED normal part of aging (37.9%), due to health condition (32.2%), ED was caused by medication (9.4%) and they were embarrassed (7.3%). Only 4.4% had sought treatment. More than one third participants (35%) had used Sildenafil while most had used other traditional medicines such as Tongkat Ali, massage and Chinese herbs. Conclusions: Self-reported erectile problem among men is common. However, ED is not a health condition that patients would commonly discuss with their doctors despite the fact that they are already seeing doctors for various other medical reasons.
A shared care approach to the management of erectile dysfunction in the community
International Journal of Impotence Research, 2002
Erectile dysfunction (ED) affects men of all ages and results in considerable distress and impact on quality of life for those who suffer from it. As ED is associated with a wide variety of underlying conditions and cardiovascular co-morbidities, there is a requirement for diversity of treatment options and several factors must be considered to customise and optimise therapy. In the ideal holistic approach to management of the ED patient, both primary care and specialist physicians have an important role to play. This article reports on a sequential approach for the diagnosis and treatment of ED, with an emphasis on 'shared care'. The deliberations are based on a pan-European inter-disciplinary group that met at