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Published in: International Journal of Clinical Pharmacy 4/2021

01-08-2021 | Erectile Dysfunction | Research Article

Pharmacological treatment and inappropriate prescriptions for patients with erectile dysfunction

Authors: Luis Fernando Valladales-Restrepo, Jorge Enrique Machado-Alba

Published in: International Journal of Clinical Pharmacy | Issue 4/2021

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Abstract

Background Erectile dysfunction is associated with old age, some morbidities and the use of certain medications. Objective To identify the treatments and drugs related to worsening sexual activity in patients with erectile dysfunction. Setting Patients diagnosed with erectile dysfunction during 2018. Methods This cross-sectional study of a population database identified all drug prescriptions of patients with erectile dysfunction during 2018. Main outcome measure The identification of other comorbidities and potentially inappropriate drugs that could worsen erectile dysfunction. Results A total of 2999 patients with erectile dysfunction (mean age 59.6 ± 12.1 years) were identified. A total of 88.2% received pharmacological treatment for erectile dysfunction, mainly tadalafil (70.5%). A total of 47.6% of all patients received at least one medication associated with worsening erectile dysfunction, especially hydrochlorothiazide (17.0%), metoprolol (7.9%) and sertraline (6.7%). Residing in Cali (OR 1.86; 95% CI 1.52–22.27) or Bucaramanga (OR 2.23; 95% CI 1.39–33.58), having 3 or more chronic comorbidities (OR 1.52; 95% CI 1.04–2.24) and presenting psychiatric (OR 5.5; 95% CI 3.70–8.17), cardiovascular (OR 3.48; 95% CI 2.79–4.33), genitourinary (OR 1.31; 95% CI 1.05–1.64) pathologies or chronic kidney failure (OR 1.84; 95% CI 1.18–2.21) elevated the probability of receiving these prescriptions. Conclusions The pharmacological treatment of erectile dysfunction was in accordance with the recommendations of clinical practice guidelines, but the high proportion of potentially inappropriate prescriptions makes it necessary to promote educational and pharmacovigilance strategies that improve the prescription habits of physicians involved in caring for this group of patients.
Literature
1.
go back to reference Hatzimouratidis K, Salonia A, Adaikan G, Buvat J, Carrier S, El-Meliegy A, et al. Pharmacotherapy for erectile dysfunction: recommendations from the fourth international consultation for sexual medicine (ICSM 2015). J Sex Med. 2016;13(4):465–88.CrossRef Hatzimouratidis K, Salonia A, Adaikan G, Buvat J, Carrier S, El-Meliegy A, et al. Pharmacotherapy for erectile dysfunction: recommendations from the fourth international consultation for sexual medicine (ICSM 2015). J Sex Med. 2016;13(4):465–88.CrossRef
2.
go back to reference Hackett G, Kirby M, Wylie K, Heald A, Ossei-Gerning N, Edwards D, et al. British society for sexual medicine guidelines on the management of erectile dysfunction in men-2017. J Sex Med. 2018;15(4):430–57.CrossRef Hackett G, Kirby M, Wylie K, Heald A, Ossei-Gerning N, Edwards D, et al. British society for sexual medicine guidelines on the management of erectile dysfunction in men-2017. J Sex Med. 2018;15(4):430–57.CrossRef
3.
go back to reference Calogero AE, Burgio G, Condorelli RA, Cannarella R, La Vignera S. Epidemiology and risk factors of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction. Aging Male. 2019;22(1):12–9.CrossRef Calogero AE, Burgio G, Condorelli RA, Cannarella R, La Vignera S. Epidemiology and risk factors of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction. Aging Male. 2019;22(1):12–9.CrossRef
4.
go back to reference Rosen RC, Fisher WA, Eardley I, Niederberger C, Nadel A, Sand M. The multinational Men’s Attitudes to Life Events and Sexuality (MALES) study: I—prevalence of erectile dysfunction and related health concerns in the general population. Curr Med Res Opin. 2004;20(5):607–17.CrossRef Rosen RC, Fisher WA, Eardley I, Niederberger C, Nadel A, Sand M. The multinational Men’s Attitudes to Life Events and Sexuality (MALES) study: I—prevalence of erectile dysfunction and related health concerns in the general population. Curr Med Res Opin. 2004;20(5):607–17.CrossRef
5.
go back to reference Hawksworth DJ, Burnett AL. Pharmacotherapeutic management of erectile dysfunction. Clin Pharmacol Ther. 2015;98(6):602–10.CrossRef Hawksworth DJ, Burnett AL. Pharmacotherapeutic management of erectile dysfunction. Clin Pharmacol Ther. 2015;98(6):602–10.CrossRef
6.
go back to reference Kaya E, Sikka SC, Kadowitz PJ, Gur S. Aging and sexual health: getting to the problem. Aging Male. 2017;20(2):65–80.CrossRef Kaya E, Sikka SC, Kadowitz PJ, Gur S. Aging and sexual health: getting to the problem. Aging Male. 2017;20(2):65–80.CrossRef
7.
go back to reference Frederick LR, Cakir OO, Arora H, Helfand BT, McVary KT. Undertreatment of erectile dysfunction: claims analysis of 62 million patients. J Sex Med. 2014;11(10):2546–53.CrossRef Frederick LR, Cakir OO, Arora H, Helfand BT, McVary KT. Undertreatment of erectile dysfunction: claims analysis of 62 million patients. J Sex Med. 2014;11(10):2546–53.CrossRef
8.
go back to reference Evans JD, Hill SR. A comparison of the available phosphodiesterase-5 inhibitors in the treatment of erectile dysfunction: a focus on avanafil. Patient Prefer Adher. 2015;9:1159–64.CrossRef Evans JD, Hill SR. A comparison of the available phosphodiesterase-5 inhibitors in the treatment of erectile dysfunction: a focus on avanafil. Patient Prefer Adher. 2015;9:1159–64.CrossRef
9.
go back to reference Köhler TS, McVary KT. Contemporary treatment of erectile dysfunction: a clinical guide. New York: Springer; 2016. ISBN 978-3-319-31587-4.CrossRef Köhler TS, McVary KT. Contemporary treatment of erectile dysfunction: a clinical guide. New York: Springer; 2016. ISBN 978-3-319-31587-4.CrossRef
10.
go back to reference Razdan S, Greer AB, Patel A, Alameddine M, Jue JS, Ramasamy R. Effect of prescription medications on erectile dysfunction. Postgrad Med J. 2018;94(1109):171–8.CrossRef Razdan S, Greer AB, Patel A, Alameddine M, Jue JS, Ramasamy R. Effect of prescription medications on erectile dysfunction. Postgrad Med J. 2018;94(1109):171–8.CrossRef
11.
go back to reference Chen L, Shi G, Huang D, Li Y, Ma C, Shi M, et al. Male sexual dysfunction: a review of literature on its pathological mechanisms, potential risk factors, and herbal drug intervention. Biomed Pharmacother. 2019;112:108585.CrossRef Chen L, Shi G, Huang D, Li Y, Ma C, Shi M, et al. Male sexual dysfunction: a review of literature on its pathological mechanisms, potential risk factors, and herbal drug intervention. Biomed Pharmacother. 2019;112:108585.CrossRef
12.
go back to reference Caskurlu T, Tasci AI, Resim S, Sahinkanat T, Ergenekon E. The etiology of erectile dysfunction and contributing factors in different age groups in Turkey. Int J Urol. 2004;11(7):525–9.CrossRef Caskurlu T, Tasci AI, Resim S, Sahinkanat T, Ergenekon E. The etiology of erectile dysfunction and contributing factors in different age groups in Turkey. Int J Urol. 2004;11(7):525–9.CrossRef
13.
go back to reference Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200(3):633–41.CrossRef Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200(3):633–41.CrossRef
14.
go back to reference Tsai WK, Jiann BP. Data on the utilization of treatment modalities for ED in Taiwan in the era of PDE5 inhibitors. Int J Impot Res. 2014;26(4):141–5.CrossRef Tsai WK, Jiann BP. Data on the utilization of treatment modalities for ED in Taiwan in the era of PDE5 inhibitors. Int J Impot Res. 2014;26(4):141–5.CrossRef
15.
go back to reference Martin Morales A, Hatzichristou D, Ramon Llados J, Pascual Renedo V, Pimenidou A. Community pharmacy detection of erectile dysfunction in men with risk factors or who seek treatment or advice but lack a valid prescription. J Sex Med. 2013;10(9):2303–11.CrossRef Martin Morales A, Hatzichristou D, Ramon Llados J, Pascual Renedo V, Pimenidou A. Community pharmacy detection of erectile dysfunction in men with risk factors or who seek treatment or advice but lack a valid prescription. J Sex Med. 2013;10(9):2303–11.CrossRef
16.
go back to reference Kloner RA, Goggin P, Goldstein I, Hackett G, Kirby MG, Osterloh I, et al. A new perspective on the nitrate-phosphodiesterase type 5 inhibitor interaction. J Cardiovasc Pharmacol Ther. 2018;23(5):375–86.CrossRef Kloner RA, Goggin P, Goldstein I, Hackett G, Kirby MG, Osterloh I, et al. A new perspective on the nitrate-phosphodiesterase type 5 inhibitor interaction. J Cardiovasc Pharmacol Ther. 2018;23(5):375–86.CrossRef
17.
go back to reference Cairoli C, Reyes LA, Henneges C, Sorsaburu S. PDE5 inhibitor treatment persistence and adherence in Brazilian men: post hoc analyses from a 6-month, prospective. Observational study. Int Braz J Urol. 2014;40(3):390–9.CrossRef Cairoli C, Reyes LA, Henneges C, Sorsaburu S. PDE5 inhibitor treatment persistence and adherence in Brazilian men: post hoc analyses from a 6-month, prospective. Observational study. Int Braz J Urol. 2014;40(3):390–9.CrossRef
18.
go back to reference Huri HZ, Ling CF, Razack AHA. Drug-related problems in patients with erectile dysfunctions and multiple comorbidities. Ther Clin Risk Manag. 2017;13:407–19.CrossRef Huri HZ, Ling CF, Razack AHA. Drug-related problems in patients with erectile dysfunctions and multiple comorbidities. Ther Clin Risk Manag. 2017;13:407–19.CrossRef
19.
go back to reference Colson MH, Cuzin B, Faix A, Grellet L, Huyghes E. Current epidemiology of erectile dysfunction, an update. Sexologies. 2018;27(1):e7–13.CrossRef Colson MH, Cuzin B, Faix A, Grellet L, Huyghes E. Current epidemiology of erectile dysfunction, an update. Sexologies. 2018;27(1):e7–13.CrossRef
20.
go back to reference May M, Gralla O, Knoll N, Fenske S, Spivak I, Ronnebeck C, et al. Erectile dysfunction, discrepancy between high prevalence and low utilization of treatment options: results from the ‘Cottbus Survey’ with 10,000 men. BJU Int. 2007;100(5):1110–5.PubMed May M, Gralla O, Knoll N, Fenske S, Spivak I, Ronnebeck C, et al. Erectile dysfunction, discrepancy between high prevalence and low utilization of treatment options: results from the ‘Cottbus Survey’ with 10,000 men. BJU Int. 2007;100(5):1110–5.PubMed
21.
go back to reference Mutha AS, Kulkarni VR, Bhagat SB, Beldar AS, Patel SB. An observational study to evaluate the prevalence of erectile dysfunction (ED) and prescribing pattern of drugs in patients with ED visiting an andrology specialty clinic, mumbai: 2012–2014. J Clin Diagn Res. 2015;9(7):PC08–11.PubMedPubMedCentral Mutha AS, Kulkarni VR, Bhagat SB, Beldar AS, Patel SB. An observational study to evaluate the prevalence of erectile dysfunction (ED) and prescribing pattern of drugs in patients with ED visiting an andrology specialty clinic, mumbai: 2012–2014. J Clin Diagn Res. 2015;9(7):PC08–11.PubMedPubMedCentral
22.
go back to reference Zaman Huri H, Lian Choo T, Sulaiman CZ, Mark R, Abdul Razack AH. Oral drug treatments in patients with erectile dysfunction and multiple comorbidities: a retrospective observational study. BMJ Open. 2014;4(7):e005381.CrossRef Zaman Huri H, Lian Choo T, Sulaiman CZ, Mark R, Abdul Razack AH. Oral drug treatments in patients with erectile dysfunction and multiple comorbidities: a retrospective observational study. BMJ Open. 2014;4(7):e005381.CrossRef
23.
go back to reference Tsertsvadze A, Fink HA, Yazdi F, MacDonald R, Bella AJ, Ansari MT, et al. Oral phosphodiesterase-5 inhibitors and hormonal treatments for erectile dysfunction: a systematic review and meta-analysis. Ann Intern Med. 2009;151(9):650–61.CrossRef Tsertsvadze A, Fink HA, Yazdi F, MacDonald R, Bella AJ, Ansari MT, et al. Oral phosphodiesterase-5 inhibitors and hormonal treatments for erectile dysfunction: a systematic review and meta-analysis. Ann Intern Med. 2009;151(9):650–61.CrossRef
24.
go back to reference Moore RA, Derry S, McQuay HJ. Indirect comparison of interventions using published randomised trials: systematic review of PDE-5 inhibitors for erectile dysfunction. BMC Urol. 2005;5:18.CrossRef Moore RA, Derry S, McQuay HJ. Indirect comparison of interventions using published randomised trials: systematic review of PDE-5 inhibitors for erectile dysfunction. BMC Urol. 2005;5:18.CrossRef
25.
go back to reference Valladales-Restrepo LF, Machado-Alba JE. Potentially inappropriate prescriptions of anticholinergic drugs in patients with benign prostatic hyperplasia. Aging Male. 2019;2019:1–8. Valladales-Restrepo LF, Machado-Alba JE. Potentially inappropriate prescriptions of anticholinergic drugs in patients with benign prostatic hyperplasia. Aging Male. 2019;2019:1–8.
26.
go back to reference Calogero AE, Burgio G, Condorelli RA, Cannarella R, La Vignera S. Treatment of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction. Aging Male. 2018;21(4):272–80.CrossRef Calogero AE, Burgio G, Condorelli RA, Cannarella R, La Vignera S. Treatment of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction. Aging Male. 2018;21(4):272–80.CrossRef
27.
go back to reference Favilla V, Russo GI, Privitera S, Castelli T, Giardina R, Calogero AE, et al. Impact of combination therapy 5-alpha reductase inhibitors (5-ARI) plus alpha-blockers (AB) on erectile dysfunction and decrease of libido in patients with LUTS/BPH: a systematic review with meta-analysis. Aging Male. 2016;19(3):175–81.CrossRef Favilla V, Russo GI, Privitera S, Castelli T, Giardina R, Calogero AE, et al. Impact of combination therapy 5-alpha reductase inhibitors (5-ARI) plus alpha-blockers (AB) on erectile dysfunction and decrease of libido in patients with LUTS/BPH: a systematic review with meta-analysis. Aging Male. 2016;19(3):175–81.CrossRef
28.
go back to reference Mónica FZ, De Nucci G. Tadalafil for the treatment of benign prostatic hyperplasia. Expert Opin Pharmacother. 2019;20(8):929–37.CrossRef Mónica FZ, De Nucci G. Tadalafil for the treatment of benign prostatic hyperplasia. Expert Opin Pharmacother. 2019;20(8):929–37.CrossRef
29.
go back to reference Yafi FA, Jenkins L, Albersen M, Corona G, Isidori AM, Goldfarb S, et al. Erectile dysfunction. Nat Rev Dis Primers. 2016;2:16003.CrossRef Yafi FA, Jenkins L, Albersen M, Corona G, Isidori AM, Goldfarb S, et al. Erectile dysfunction. Nat Rev Dis Primers. 2016;2:16003.CrossRef
30.
go back to reference Hallanzy J, Kron M, Goethe VE, Köhn F-M, Schmautz M, Arsov C, et al. Erectile dysfunction in 45-year-old heterosexual german men and associated lifestyle risk factors and comorbidities: results from the german male sex study. Sex Med. 2019;7(1):26–34.CrossRef Hallanzy J, Kron M, Goethe VE, Köhn F-M, Schmautz M, Arsov C, et al. Erectile dysfunction in 45-year-old heterosexual german men and associated lifestyle risk factors and comorbidities: results from the german male sex study. Sex Med. 2019;7(1):26–34.CrossRef
31.
go back to reference Davies EA, O’Mahony MS. Adverse drug reactions in special populations—the elderly. Br J Clin Pharmacol. 2015;80(4):796–807.CrossRef Davies EA, O’Mahony MS. Adverse drug reactions in special populations—the elderly. Br J Clin Pharmacol. 2015;80(4):796–807.CrossRef
32.
go back to reference Kupelian V, Hall SA, McKinlay JB. Common prescription medication use and erectile dysfunction: results from the Boston Area Community Health (BACH) survey. BJU Int. 2013;112(8):1178–87.CrossRef Kupelian V, Hall SA, McKinlay JB. Common prescription medication use and erectile dysfunction: results from the Boston Area Community Health (BACH) survey. BJU Int. 2013;112(8):1178–87.CrossRef
33.
go back to reference Bjerkeli PJ, Mulinari S, Zettermark S, Merlo J. Sociodemographic patterns in pharmacy dispensing of medications for erectile dysfunction in Sweden. Eur J Clin Pharmacol. 2018;74(2):209–18.CrossRef Bjerkeli PJ, Mulinari S, Zettermark S, Merlo J. Sociodemographic patterns in pharmacy dispensing of medications for erectile dysfunction in Sweden. Eur J Clin Pharmacol. 2018;74(2):209–18.CrossRef
34.
go back to reference Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021–104.CrossRef Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021–104.CrossRef
35.
go back to reference Zainol M, Sidi H, Kumar J, Das S, Ismail SB, Hatta MH, et al. Co-morbid erectile dysfunction (ED) and antidepressant treatment in a patient—a management challenge? Curr Drug Targets. 2019;20(2):182–91.CrossRef Zainol M, Sidi H, Kumar J, Das S, Ismail SB, Hatta MH, et al. Co-morbid erectile dysfunction (ED) and antidepressant treatment in a patient—a management challenge? Curr Drug Targets. 2019;20(2):182–91.CrossRef
36.
go back to reference Atmaca M. Selective serotonin reuptake inhibitor-induced sexual dysfunction: current management perspectives. Neuropsychiatr Dis Treat. 2020;16:1043–50.CrossRef Atmaca M. Selective serotonin reuptake inhibitor-induced sexual dysfunction: current management perspectives. Neuropsychiatr Dis Treat. 2020;16:1043–50.CrossRef
38.
go back to reference Valladales-Restrepo LF, Duran-Lengua M, Machado-Alba JE. Potentially inappropriate prescriptions of anticholinergics drugs in Alzheimer’s disease patients. Geriatr Gerontol Int. 2019;19(9):913–7.CrossRef Valladales-Restrepo LF, Duran-Lengua M, Machado-Alba JE. Potentially inappropriate prescriptions of anticholinergics drugs in Alzheimer’s disease patients. Geriatr Gerontol Int. 2019;19(9):913–7.CrossRef
Metadata
Title
Pharmacological treatment and inappropriate prescriptions for patients with erectile dysfunction
Authors
Luis Fernando Valladales-Restrepo
Jorge Enrique Machado-Alba
Publication date
01-08-2021
Publisher
Springer International Publishing
Published in
International Journal of Clinical Pharmacy / Issue 4/2021
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-020-01194-y

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