Management of erectile dysfunction: perceptions and practices of Nigerian primary care clinicians (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.
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.
2013
Introduction. Data suggest that ED is still an underdiagnosed and undertreated condition. In addition, it seems that men with ED are unsatisfied about their relationship with their physician and with the available drugs. Aim. The study aims to identify health-related characteristics and unmet needs of patients suffering from erectile dysfunction (ED) in big 5 European Union (EU) nations (France, Germany, Italy, Spain, and UK). Methods. Data were collected from the 2011 5EU National Health and Wellness-Survey on a population of 28,511 adult men (mean age: 47.18; SD 16.07) and was focused on men (5,184) who self-reported ED in the past 6 months. In addition, the quality of life (QoL) and work productivity/activity were explored. Main Outcome Measures. Health-related QoL (HRQoL) and work productivity were measured with SF-12v2 and WPAI validated psychometric tools. Results. One in every 20 young men (age 18-39) across 5EU experienced ED in the past 6 months. About half of men (2,702/5,184; [52%]) with ED across all ages did not discuss their condition with their physician. Interestingly, among those men who did discuss their condition with their physician, 68% (1,668/2,465) do not currently use medication. These findings were more evident in the age group of 18-39 years. Only 48% (2,465/5,184) had a closer relationship with their physician, suggesting that this quality of relationship may be unsatisfactory. Compared with controls, ED patients have a significantly higher intrapsychic and relational psychopathological comorbid burden and relevant decreasing in HRQoL, with a significantly higher impairment on work productivity/activity. Conclusion. Data suggest that there is a need for a new therapeutic paradigm in ED treatment which images the achievement of a new alliance between physician and patient. Hence, alternative drug delivery strategies may reduce the psychological and social impact of this disease. Jannini EA,
The role of general practitioners in the management of erectile dysfunction—a qualitative study
International Journal of Impotence Research, 2004
The objective of this study was to explore the roles and perceptions of general practitioners (GPs) in the management of erectile dysfunction (ED). This qualitative study used focus group discussions and in-depth interviews. This study was conducted based on 28 GPs from an urban area in Malaysia who had managed patients with ED and prescribed anti-ED drugs. Main outcome measures included the roles of GPs in managing patients with ED (active or passive), perceptions regarding ED and the treatment, and factors influencing their decision to prescribe. Majority of the GPs assumed a passive role when managing patients with ED. This was partly due to their perception of the disease being nonserious. Some also perceived ED as mainly psychological in nature. The anti-ED drugs were often viewed as a lifestyle drug with potentially serious side effects. The fear of being perceived by patients as 'pushing' for the drug and being blamed if the patients were to develop serious side effects also hampered the management of this disease. GPs who participated in this study remained passive in identifying and treating patients with ED and this was attributed to their perception of the disease, drug treatment and patient's background.
Erectile Dysfunction: Clinical Guidelines (2).
Urology Journal, 2004
Purpose: According to a survey, the Massachusetts Male Aging Study, 52% of men beyond 40 years of age may have some degrees of erectile failure, and it is projected to affect 322 million men worldwide by 2025. We present a framework for the evaluation , treatment, and follow-up of the male patient who presents with erectile dysfunc-tion. Materials and Methods: A comprehensive review of the literature was conducted using the MEDLINE database for all articles from 1975 through 2004 on male sexual dysfunction and the most pertinent articles are discussed. Results: Remarkable progress has been made in the treatment of erectile dysfunc-tion (ED). Erectile dysfunction is a common condition associated with aging, chronic illnesses and various modifiable risk factors. Erectile dysfunction can be due to vascu-logenic, neurogenic, hormonal, and/or psychogenic factors as well as alterations in the nitric oxide/cyclic guanosine monophosphate pathway or other regulatory mechanisms. The number of consultations from new patients presenting with erectile dys-function and resulting costs for health care systems are increasing. Urologist should be the evaluating physician who supervises the surgical, medical, and hormonal treatment and who refers the patient, as necessary, to other members of the multidisciplinary team. Conclusion: Erectile dysfunction has a significant negative impact on quality of life. Male sexual dysfunction, especially erectile dysfunction, necessitates a comprehensive medical and psychologic evaluation involving both partners. All possible risk factors should be outlined and corrected, when feasible. The first step in the management of a patient with ED is to facilitate the patient's and his part-ner's (if available) understanding of the condition , the results of the diagnostic assessment and to identify the patient's and his partner's needs, expectations, priorities, and preferences. The identification and recognition of associated medical and psychological factors in the individual patient must be emphasized. Clearly, the selection of therapy is strongly influenced by personal, cultural , ethnic, religious, and economic (affordabili-ty) factors. The presentation and stratification of therapies may therefore vary from individual to individual, culture-to-culture, religious persuasion to religious persuasion, and from one economic tier to another. Sensitivity to these factors is important in determining the long-term success of any selected therapeutic course. Prior to direct intervention, good medical practice recognizes the value of altering modifiable risk factors, and this step alone may be of some value in selected patients. The patient and his partner (if available) should
Please cite this article in press as: Irekpita E, et al. Clinical, cultural and psychosocial impediments to self reporting of erectile dysfunction (ED) by men in Edo state, Nigeria. Afr J Urol (2017), http://dx. Abstract Introduction: Organic ED is presently considered as vasculogenic in the majority of affected middle age and elderly men and a sentinel event for cardiovascular disease. When men present with ED, it is advised that the opportunity should be used to assess their cardiovascular health. Objective: To determine the impediments to self reporting of ED and to assess the help seeking habits of men in Edo state with regards to ED. The secondary objective is to evaluate how acceptable sexual assessment is to these men when they present. Subjects and methods: This is a cross sectional study using a multi-facet, questionnaire with a section consisting of the international index of erectile function (IIEF). All men above 30 years who consented were included. Results: The response rate was 71.1%. The mean IIEF score was 20.33 with standard deviation of 4.656. The overall prevalence of ED was 51.2. Three hundred and eight of the respondents (33.3%) did not know where ED is treated, 273 (29.5%) thought that it is treated by complementary and alternative medicine practitioners while 237 (25.6) opted for the hospital as a point of care. This had a statistically significant correlation with location of the respondent (P = 0.000), level of education (P = 0.000) and senatorial zone (P = 0.000). Sexual evaluation was acceptable to 384 (41.5%) respondents when men present without ED and 757 (81.8%) when ED has occurred. This had a statistically significant correlation with level of education (P = 0.000), alcohol consumption (P = 0.000) and senatorial zone (P = 0.000).
2006
Introduction. The Erectile Dysfunction Observational Study (EDOS) is a 6-month, pan-European prospective, observational study of health outcomes designed to assess patients' profiles and characteristics and the effectiveness of erectile dysfunction (ED) treatment in routine clinical practice Aim. To present baseline characteristics and treatment-seeking behavior of a large sample of ED patients recruited in real-life clinical settings. Methods. Men aged 18 years and older who visited a physician to initiate or change any ED treatment were enrolled in EDOS. They were assessed at baseline, 3 months, and 6 months as part of their normal course of care in nine European countries. Main Outcome Measures. Sexual health outcomes using the short form of the Psychological and Interpersonal Relationship Scales. Treatment effectiveness and satisfaction were assessed using the International Index of Erectile Function questionnaire, Global Assessment Questions, and further single-item questions. Results. Of the 8,186 patients enrolled by 904 investigators (69% general practitioners [GPs]) across nine European countries, 8,055 patients were eligible for analysis at baseline; 63.9% were ED treatment-naive. Of the total patient population, mean age was 56.5 years, mean body mass index (BMI) was 27.2 kg/m 2 , 18.3% were obese (BMI > 30 kg/m 2), 42.5% had severe ED, and there was a high frequency of comorbidities and concomitant medication use. A similar proportion of the treatment-naive patients were seen by GPs (62.9%) and specialists (65.8%). In the treatment-naive group, there was a higher frequency of severe ED among ex-smokers, obese patients, and in those who drank no alcohol or excessive amounts of alcohol. Conclusions. Unmet need of treatment in ED is high; 66% of patients had experienced ED symptoms for 1 year or longer when they were looking for treatment. Severity seems to be related to treatment seeking. Haro JM,
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...