ORIGINAL RESEARCH—ED PHARMACOTHERAPY: Can an Educational Program Optimize PDE5i Therapy? A Study of Canadian Primary Care Practices


Jean-Eric Tarride, PhD, Department of Clinical Epidemiology & Biostatistics, McMaster University; Program for Assessment of Technology in Health, St. Joseph's Healthcare Hamilton, 25 Main Street West, Suite 2000, Hamilton, Ontario L8P 1H1, Canada. Tel: (905) 523-7284 Ext. 5282; Fax: (905) 522-0568; E-mail: tarride@mcmaster.ca


Introduction.  The importance of patient instructions, designed to optimize therapy with phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction (ED), has recently been demonstrated.

Aim.  To evaluate the impact of an educational program for new sildenafil users against usual ED management in Canadian primary care practices.

Methods.  This multicenter, 6-month cluster randomized prospective study was conducted across Canada in general practitioners' offices where sites were randomized to receive a treatment optimization program (TOP) tool at visit 1 (TOP sites) or not to receive the TOP tool (non-TOP sites) while continuing with usual practice. Study participants were men seeking medical attention for ED and who were sildenafil naïve. The TOP tool consisted of a tear-off sheet, a brochure, and a video. Study drug was not provided to the patients. Sildenafil samples and prescriptions were dispensed as per usual care practices.

Main Outcome Measures.  The Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire was used to determine treatment satisfaction at visit 2 (month 3) and visit 3 (month 6). Patient and physician satisfaction with the TOP tool was assessed using self-reported questionnaires.

Results.  The intent-to-treat (ITT) population consisted of 2,573 patients from 231 primary care sites. At visits 2 and 3, treatment satisfaction with sildenafil was high with almost 9 patients out of 10 satisfied with treatment. No significant statistical differences were observed in the EDITS scores between the TOP and the non-TOP groups at visits 2 and 3. More than 80% of the participants were satisfied or very satisfied with the video and the brochure. More than 8 out of 10 participating physicians (84%) would use the TOP tool in their current practice if available.

Conclusions.  TOP is a valuable and time-efficient ED management tool providing benefits to newly diagnosed ED patients and to their physicians. Brock G, Carrier S, Casey R, Tarride J-E, Elliott S, Dugré H, Rousseau C, D'Angelo P, and Defoy I. Can an educational program optimize PDE5i Therapy? A study of Canadian primary care practices. J Sex Med 2007;4:1404–1413.