Misdiagnosis And Undertreatment Of Erectile Dysfunction In The Portuguese Primary Health Care
Introduction: The importance of erectile dysfunction (ED) diagnosis and treatment has been highlighted since the early 2000s. However, nearly 20 years after the first phosphodiesterase 5 inhibitor (PDE5i) was marketed, underdiagnosis and undertreatment of ED in the primary health care setting may st...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Oxford University Press
2019-06-01
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| Series: | Sexual Medicine |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2050116119300108 |
| _version_ | 1797716406618292224 |
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| author | Afonso Morgado Maria Leonor Moura Paulo Dinis, PhD Carlos Martins Silva, PhD |
| author_facet | Afonso Morgado Maria Leonor Moura Paulo Dinis, PhD Carlos Martins Silva, PhD |
| author_sort | Afonso Morgado |
| collection | DOAJ |
| description | Introduction: The importance of erectile dysfunction (ED) diagnosis and treatment has been highlighted since the early 2000s. However, nearly 20 years after the first phosphodiesterase 5 inhibitor (PDE5i) was marketed, underdiagnosis and undertreatment of ED in the primary health care setting may still be present. Aim: To assess the relative frequency of patients who are medically treated for ED before referral to specialized urology care. The secondary objectives were to evaluate possible reasons for non-treatment prior to referral and other signs of undertreatment, namely cardiovascular risk assessment and antihypertensive treatment. Methods: 200 male patients referred for ED to specialist urology care by general practitioners were screened after consent between January 2016–December 2018. A full standardized medical and sexual history were taken. Previous medical treatment of ED, namely pharmacologic name and dosages, and cardiovascular risk factors were noted. Main Outcome Measures: Of the 115 included patients, only 33.9% of patients had already taken PDE5i before referral, and none had taken alprostadil by intracavernous route. Results: The mean patient age was 58.68 ± 10.01 years old. Only 45.2% had been prescribed the highest dose of PD5i. From the remaining untreated patients, only 19.7% had ≥3 cardiovascular risk factors, including 5.6% of patients who also presented moderate-to-severe stable or unstable angina requiring a stress test or cardiology assessment before treatment. Regarding the 54 patients with medical history of arterial hypertension, 43.4% and 30.2% were treated for hypertension with a diuretic and a beta blocker, respectively. Conclusion: More focus on the primary healthcare continuous medical education regarding sexual dysfunction, namely ED, is needed because major undertreatment of ED is still present because low prescription of PD5i before referral is noted.Morgado A, Moura ML, Dinis P, et al. Misdiagnosis And Undertreatment Of Erectile Dysfunction In The Portuguese Primary Health Care. Sex Med 2019;7:177–183. Key Words: Erectile Dysfunction, Undertreatment, Primary Health Care, General Practitioner |
| first_indexed | 2024-03-12T08:20:58Z |
| format | Article |
| id | doaj.art-a5409f2c73144a628e543d5aa17049ac |
| institution | Directory Open Access Journal |
| issn | 2050-1161 |
| language | English |
| last_indexed | 2024-03-12T08:20:58Z |
| publishDate | 2019-06-01 |
| publisher | Oxford University Press |
| record_format | Article |
| series | Sexual Medicine |
| spelling | doaj.art-a5409f2c73144a628e543d5aa17049ac2023-09-02T18:29:35ZengOxford University PressSexual Medicine2050-11612019-06-0172177183Misdiagnosis And Undertreatment Of Erectile Dysfunction In The Portuguese Primary Health CareAfonso Morgado0Maria Leonor Moura1Paulo Dinis, PhD2Carlos Martins Silva, PhD3Serviço de Urologia, Centro Hospitalar São João, Porto, Portugal; Departamento de Biomedicina, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Corresponding Author: Afonso Morgado, Serviço de Urologia, Centro Hospitalar de Sao Joao, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal. Tel: 351 225 512 100; Fax: 351 225 025 766Faculdade de Medicina da Universidade do Porto, Porto, PortugalServiço de Urologia, Centro Hospitalar São João, Porto, Portugal; Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, PortugalServiço de Urologia, Centro Hospitalar São João, Porto, Portugal; Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, PortugalIntroduction: The importance of erectile dysfunction (ED) diagnosis and treatment has been highlighted since the early 2000s. However, nearly 20 years after the first phosphodiesterase 5 inhibitor (PDE5i) was marketed, underdiagnosis and undertreatment of ED in the primary health care setting may still be present. Aim: To assess the relative frequency of patients who are medically treated for ED before referral to specialized urology care. The secondary objectives were to evaluate possible reasons for non-treatment prior to referral and other signs of undertreatment, namely cardiovascular risk assessment and antihypertensive treatment. Methods: 200 male patients referred for ED to specialist urology care by general practitioners were screened after consent between January 2016–December 2018. A full standardized medical and sexual history were taken. Previous medical treatment of ED, namely pharmacologic name and dosages, and cardiovascular risk factors were noted. Main Outcome Measures: Of the 115 included patients, only 33.9% of patients had already taken PDE5i before referral, and none had taken alprostadil by intracavernous route. Results: The mean patient age was 58.68 ± 10.01 years old. Only 45.2% had been prescribed the highest dose of PD5i. From the remaining untreated patients, only 19.7% had ≥3 cardiovascular risk factors, including 5.6% of patients who also presented moderate-to-severe stable or unstable angina requiring a stress test or cardiology assessment before treatment. Regarding the 54 patients with medical history of arterial hypertension, 43.4% and 30.2% were treated for hypertension with a diuretic and a beta blocker, respectively. Conclusion: More focus on the primary healthcare continuous medical education regarding sexual dysfunction, namely ED, is needed because major undertreatment of ED is still present because low prescription of PD5i before referral is noted.Morgado A, Moura ML, Dinis P, et al. Misdiagnosis And Undertreatment Of Erectile Dysfunction In The Portuguese Primary Health Care. Sex Med 2019;7:177–183. Key Words: Erectile Dysfunction, Undertreatment, Primary Health Care, General Practitionerhttp://www.sciencedirect.com/science/article/pii/S2050116119300108 |
| spellingShingle | Afonso Morgado Maria Leonor Moura Paulo Dinis, PhD Carlos Martins Silva, PhD Misdiagnosis And Undertreatment Of Erectile Dysfunction In The Portuguese Primary Health Care Sexual Medicine |
| title | Misdiagnosis And Undertreatment Of Erectile Dysfunction In The Portuguese Primary Health Care |
| title_full | Misdiagnosis And Undertreatment Of Erectile Dysfunction In The Portuguese Primary Health Care |
| title_fullStr | Misdiagnosis And Undertreatment Of Erectile Dysfunction In The Portuguese Primary Health Care |
| title_full_unstemmed | Misdiagnosis And Undertreatment Of Erectile Dysfunction In The Portuguese Primary Health Care |
| title_short | Misdiagnosis And Undertreatment Of Erectile Dysfunction In The Portuguese Primary Health Care |
| title_sort | misdiagnosis and undertreatment of erectile dysfunction in the portuguese primary health care |
| url | http://www.sciencedirect.com/science/article/pii/S2050116119300108 |
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