The Ability of the General Male Public to Assess Their Suitability to Take 50-mg Sildenafil: An Assessment of the Comprehension of Patient Information Materials via Internet Survey

Abstract

Introduction Erectile dysfunction (ED) is the most common male sexual dysfunction and has a negative impact on masculinity and self-esteem. Phosphodiesterase type 5 inhibitors, including sildenafil, are the first-line treatment option for ED. Providing appropriate information regarding suitability for using sildenafil is important. Aim The purpose of this study was to assess whether a broad spectrum of men could appropriately evaluate their suitability for 50-mg sildenafil after reviewing patient information materials. Main Outcome Measures Patient information (Pack) on appropriate use of 50-mg sildenafil and patient information leaflet (PIL), a Web survey including demographics, self-assessed suitability for sildenafil use, and suitability screener. Methods A randomly selected, population-representative Web-based panel of males in the UK was recruited for this study. Eligible men answered a brief sociodemographic questionnaire and then were presented with the Pack. If a participant desired additional information, he could also review the PIL. The participants then rated the Pack and PIL (if reviewed), self-assessed their suitability for sildenafil use, and completed a previously validated screener for suitability. Results A total of 1,275 men aged 40 and above were included in these analyses; the mean age was 57.8 ± 9.9 years. A total of 1,054 men reported ED; 517 men (40.5%) deemed themselves suitable for sildenafil; 504 men (39.6%) deemed themselves unsuitable; and 254 (19.9%) were unsure. The concordance rate between screener-assessed suitability and self-assessed suitability was 70.9% (95% confidence interval [CI] = 68.1–73.7%). When accounting for men who would not take sildenafil even though they were suitable or would seek additional information from a healthcare professional prior to using sildenafil, the concordance rate was 84.2% (95% CI = 82.2–86.2%). Conclusion The results of this study suggest that men in the general population are capable of using written sildenafil patient education materials to accurately assess their suitability for treatment with 50-mg sildenafil.

Delay in Seeking Medical Help in Patients with New-Onset Erectile Dysfunction Remained High Over and Despite the PDE5 Era—An Ecological Study

“…It is certainly clear to everyone that they do not offer any medical counseling; therefore, we believe that many patients not only cannot evaluate the important role that ED may play as a barometer of their general health, but certainly many patients with CVD do not even assess their own suitability for PDE5 [41]. In this direction, data confirm the importance of programs aimed at educating patients to assess their own suitability for PDE5 [17]. We would point out that even at an earlier time, we should have had more effective and informative educational tools to make patients aware of the importance of ED per se in terms of their overall health.…”

“…The availability of oral therapies has given patients more confidence to reveal and consider their intimate troubles, and advances in molecular and clinical pathophysiology have invested ED with a new role in the evaluation of men's general health status [2,13,14]. Men's awareness of ED, rate of seeking medical help, communication barriers with physicians [10,15,16], potential misuse of phosphodiesterase type 5 inhibitors (PDE5) [17,18], and the emergent role of the Internet and the media [19,20] are factors that ultimately affect a patient's treatment.…”

Factors that Facilitate and Hinder the Comprehension of Patient Information Leaflets (PILs): A Brief Scoping Review

“…The leaflets must be clear and concise in their explanations and must be available in the user’s language and adapted to their understanding ( Clausen et al, 2016 ; Khodambashi et al, 2017 ). However, a considerable proportion of the leaflets evaluated in these articles did not meet these characteristics as they were not understood by the general public ( Rajasundaram et al, 2006 ; Symonds et al, 2011 ; Brooke et al, 2013 ; Spinillo, 2014 ; Bennin and Rother, 2015 ; Alaqeel and al Obaidi, 2017 ; Haller et al, 2019 ), nor did they meet the parameters of utility ( Sukkari et al, 2012 ), readability ( Kasesnik and Kline, 2011 ), adaptation to the educational level of the target population ( Cronin et al, 2011 ), or use of non-medical terminology ( Hirsh et al, 2009 ; Bennin and Rother, 2015 ). Participants in other studies confirmed that the leaflets were clear, legible ( Gustafsson et al, 2005 ; Williamson and Martin, 2010 ; Potter et al, 2014 ), and useful ( Edwards et al, 2013 ), even though the participants showed low scores in a test on knowledge acquired from the PILs ( Alaqeel and al Obaidi, 2017 ).…”

“…Although it is difficult to understand the leaflets, patients showed a great interest in learning about medicinal products ( Hirsh et al, 2009 ), so they tended to search the internet for some prototypes of virtual leaflets that provided them with information easily and quickly ( Afreh et al, 2017 ; Dickinson et al, 2017 ; Ahmadi et al, 2019 ). Further, the advice of a health professional that complements the information in the leaflets increases adherence to treatment ( Ashok et al, 2017 ) and the active search for information ( Symonds et al, 2011 ; Potter et al, 2014 ). In addition, people’s opinion of the leaflets are based, above all, on the healthcare professionals’ recommendations on the use of medicinal products and their benefits, main characteristics ( Kohler et al, 2009 ), and side effects ( Schmitz et al, 2017 ).…”

A Feasibility Study Comparing Pharmacist and Physician Recommendations for Sildenafil Treatment

“…Thus, community pharmacists can play an important role in identifying patients with ED, providing education and counseling on potential cardiovascular risk factors and recommending further medical care [12]. A reminder for further medical care to check for potential underlying conditions was also highlighted in a more recent version of the patient‐screening questionnaire, used in subsequent research [27].…”