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Published in: Trials 1/2018

Open Access 01-12-2018 | Study protocol

Premature ejaculation in primary care: communication strategies versus usual care for male patients consulting for a sexual, urogenital or psychological reason – GET UP: study protocol for a cluster randomised controlled trial

Authors: Marie Barais, Hélène Vaillant Roussel, David Costa, Jérémy Derriennic, Bruno Pereira, Sébastien Cadier

Published in: Trials | Issue 1/2018

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Abstract

Background

Premature ejaculation (PE) is the most common sexual dysfunction among men. According to patients, the general practitioner (GP) is the appropriate professional with whom to discuss this issue. However, few patients receive the medical help needed because GPs find it difficult to talk to their patients about sex. A previous qualitative study provided six strategies described by GPs who had tackled the topic during consultation. A pilot study showed that using one of these strategies after a training course led to an increase in the rate of consultations where the topic was raised: an increase from 6.6 to 30.8%. The aim of this study is to compare whether training in communication skills with these six strategies is more effective than usual care on the incidence of patients bringing up the topic of PE with their GP.

Methods

A cluster randomised controlled trial, stratified over four areas comparing an intervention group, which will receive the six strategies training session, and a control group, which ensures routine medical care. The primary outcome is to investigate the efficacy of a training in communication skills directed towards this pathology, compared with usual care procedures, on the incidence of patients bringing up the topic of PE with their GP. The secondary objective relates to the variation in the quality of life of patients after having recently addressed the topic of PE. Quality of life will be evaluated using the SF-12 health scale, with scoring filled in by the patient immediately after the consultation and 4 weeks later. The patients suffering from PE will be identified if their score is higher than 9 on the Premature Ejaculation Diagnostic Tool filled in 4 weeks after the consultation. The number of patients necessary to highlight a significant difference between the two groups from 5 to 20% is 101. Therefore, a total of 600 patients is expected, 300 in each arm (40 GPs, 15 patients per GP; risk α = 5%; power = 90%; intra-cluster correlation coefficient ρ = 0.2; Hawthorne effect = 15%; lost-to-follow-up rates for GPs = 10% and for patients = 20%).

Discussion

The implication for practice is the improvement in the quality of patient-centred care within a topic area which encompasses almost 30% of male sex-related complaints.

Trial registration

ClinicalTrials.gov, ID: NCT02378779. Registered on 3 February 2015.
Appendix
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Literature
1.
go back to reference Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, et al. Sexual problems among women and men aged 40–80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res. 2005;17:39–57.CrossRef Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, et al. Sexual problems among women and men aged 40–80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res. 2005;17:39–57.CrossRef
2.
go back to reference Nicolosi A, Laumann EO, Glasser DB, Moreira EDJ, Paik A, Gingell C. Sexual behavior and sexual dysfunctions after age 40: the global study of sexual attitudes and behaviors. Urology. 2004;64:991–7.CrossRef Nicolosi A, Laumann EO, Glasser DB, Moreira EDJ, Paik A, Gingell C. Sexual behavior and sexual dysfunctions after age 40: the global study of sexual attitudes and behaviors. Urology. 2004;64:991–7.CrossRef
3.
go back to reference Rosen RC, Althof S. Impact of premature ejaculation: the psychological, quality of life, and sexual relationship consequences. J Sex Med. 2008;5:1296–307.CrossRef Rosen RC, Althof S. Impact of premature ejaculation: the psychological, quality of life, and sexual relationship consequences. J Sex Med. 2008;5:1296–307.CrossRef
4.
go back to reference Porst H, Montorsi F, Rosen RC, Gaynor L, Grupe S, Alexander J. The Premature Ejaculation Prevalence and Attitudes (PEPA) survey: prevalence, comorbidities, and professional help-seeking. Eur Urol. 2007;51:816–23.CrossRef Porst H, Montorsi F, Rosen RC, Gaynor L, Grupe S, Alexander J. The Premature Ejaculation Prevalence and Attitudes (PEPA) survey: prevalence, comorbidities, and professional help-seeking. Eur Urol. 2007;51:816–23.CrossRef
5.
go back to reference Waldinger MD, McIntosh J, Schweitzer DH. A five-nation survey to assess the distribution of the intravaginal ejaculatory latency time among the general male population. J Sex Med. 2009;6:2888–95.CrossRef Waldinger MD, McIntosh J, Schweitzer DH. A five-nation survey to assess the distribution of the intravaginal ejaculatory latency time among the general male population. J Sex Med. 2009;6:2888–95.CrossRef
6.
go back to reference Serefoglu EC, Saitz TR. New insights on premature ejaculation: a review of definition, classification, prevalence and treatment. Asian J Androl. 2012;14:822–9.CrossRef Serefoglu EC, Saitz TR. New insights on premature ejaculation: a review of definition, classification, prevalence and treatment. Asian J Androl. 2012;14:822–9.CrossRef
7.
go back to reference Serefoglu EC, McMahon CG, Waldinger MD, Althof SE, Shindel A, Adaikan G, et al. An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second international society for sexual medicine ad hoc committee for the definition of premature ejaculation. Sex Med. 2014;2:41–59.CrossRef Serefoglu EC, McMahon CG, Waldinger MD, Althof SE, Shindel A, Adaikan G, et al. An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second international society for sexual medicine ad hoc committee for the definition of premature ejaculation. Sex Med. 2014;2:41–59.CrossRef
8.
go back to reference McMahon CG, Althof S, Waldinger MD, Porst H, Dean J, Sharlip I, et al. An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. BJU Int. 2008;102:338–50.CrossRef McMahon CG, Althof S, Waldinger MD, Porst H, Dean J, Sharlip I, et al. An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. BJU Int. 2008;102:338–50.CrossRef
9.
go back to reference Althof SE, McMahon CG, Waldinger MD, Serefoglu EC, Shindel AW, Adaikan PG, et al. An update of the International Society of Sexual Medicine’s guidelines for the diagnosis and treatment of premature ejaculation (PE). J Sex Med. 2014;11:1392–422.CrossRef Althof SE, McMahon CG, Waldinger MD, Serefoglu EC, Shindel AW, Adaikan PG, et al. An update of the International Society of Sexual Medicine’s guidelines for the diagnosis and treatment of premature ejaculation (PE). J Sex Med. 2014;11:1392–422.CrossRef
10.
go back to reference Althof SE, Abdo CHN, Dean J, Hackett G, McCabe M, McMahon CG, et al. International Society for Sexual Medicine’s guidelines for the diagnosis and treatment of premature ejaculation. J Sex Med. 2010;7:2947–69.CrossRef Althof SE, Abdo CHN, Dean J, Hackett G, McCabe M, McMahon CG, et al. International Society for Sexual Medicine’s guidelines for the diagnosis and treatment of premature ejaculation. J Sex Med. 2010;7:2947–69.CrossRef
11.
go back to reference Aschka C, Himmel W, Ittner E, Kochen MM. Sexual problems of male patients in family practice. J Fam Pract. 2001;50:773–8.PubMed Aschka C, Himmel W, Ittner E, Kochen MM. Sexual problems of male patients in family practice. J Fam Pract. 2001;50:773–8.PubMed
12.
go back to reference Humphery S, Nazareth I. GPs’ views on their management of sexual dysfunction. Fam Pract. 2001;18:516–8.CrossRef Humphery S, Nazareth I. GPs’ views on their management of sexual dysfunction. Fam Pract. 2001;18:516–8.CrossRef
13.
go back to reference Gott M, Galena E, Hinchliff S, Elford H. ‘Opening a can of worms’: GP and practice nurse barriers to talking about sexual health in primary care. Fam Pract. 2004;21:528–36.CrossRef Gott M, Galena E, Hinchliff S, Elford H. ‘Opening a can of worms’: GP and practice nurse barriers to talking about sexual health in primary care. Fam Pract. 2004;21:528–36.CrossRef
14.
go back to reference Temple-Smith M, Hammond J, Pyett P, Presswell N. Barriers to sexual history taking in general practice. Aust Fam Physician. 1996;25:S71–4.PubMed Temple-Smith M, Hammond J, Pyett P, Presswell N. Barriers to sexual history taking in general practice. Aust Fam Physician. 1996;25:S71–4.PubMed
15.
go back to reference Temple-Smith MJ, Mulvey G, Keogh L. Attitudes to taking a sexual history in general practice in Victoria, Australia. Sex Transm Infect. 1999;75:41–4.CrossRef Temple-Smith MJ, Mulvey G, Keogh L. Attitudes to taking a sexual history in general practice in Victoria, Australia. Sex Transm Infect. 1999;75:41–4.CrossRef
16.
go back to reference Dyer K, Hons B, Das Nair R, Cpsychol A, Med JS. Why don’t healthcare professionals talk about sex? A systematic review of recent qualitative studies conducted in the united kingdom. J Sex Med. 2013;10:2658–70.CrossRef Dyer K, Hons B, Das Nair R, Cpsychol A, Med JS. Why don’t healthcare professionals talk about sex? A systematic review of recent qualitative studies conducted in the united kingdom. J Sex Med. 2013;10:2658–70.CrossRef
17.
go back to reference Tsimtsiou Z, Hatzimouratidis K, Nakopoulou E, Kyrana E, Salpigidis G, Hatzichristou D. Predictors of physicians’ involvement in addressing sexual health issues. J Sex Med. 2006;3:583–8.CrossRef Tsimtsiou Z, Hatzimouratidis K, Nakopoulou E, Kyrana E, Salpigidis G, Hatzichristou D. Predictors of physicians’ involvement in addressing sexual health issues. J Sex Med. 2006;3:583–8.CrossRef
18.
go back to reference de Carufel F, Trudel G. Effects of a new functional-sexological treatment for premature ejaculation. J Sex Marital Ther. 2006;32:97–114.CrossRef de Carufel F, Trudel G. Effects of a new functional-sexological treatment for premature ejaculation. J Sex Marital Ther. 2006;32:97–114.CrossRef
19.
go back to reference Melnik T, Glina S, Rodrigues OMJ. Psychological intervention for premature ejaculation. Nat Rev Urol. 2009;6:501–8.CrossRef Melnik T, Glina S, Rodrigues OMJ. Psychological intervention for premature ejaculation. Nat Rev Urol. 2009;6:501–8.CrossRef
20.
go back to reference Kempeneers P, Andrianne R, Bauwens S, Georis I, Pairoux J-F, Blairy S. Clinical outcomes of a new self-help booklet for premature ejaculation. J Sex Med. 2012;9:2417–28.CrossRef Kempeneers P, Andrianne R, Bauwens S, Georis I, Pairoux J-F, Blairy S. Clinical outcomes of a new self-help booklet for premature ejaculation. J Sex Med. 2012;9:2417–28.CrossRef
23.
go back to reference Letrilliart L, Rigault-Fossier P, Fossier B, Kellou N, Paumier F, Bois C, et al. Comparison of French training and non-training general practices: a cross-sectional study. BMC Med Educ. 2016;16:126.CrossRef Letrilliart L, Rigault-Fossier P, Fossier B, Kellou N, Paumier F, Bois C, et al. Comparison of French training and non-training general practices: a cross-sectional study. BMC Med Educ. 2016;16:126.CrossRef
24.
go back to reference Thompson BT, Schoenfeld D. Usual care as the control group in clinical trials of nonpharmacologic interventions. Proc Am Thorac Soc. 2007;4:577–82.CrossRef Thompson BT, Schoenfeld D. Usual care as the control group in clinical trials of nonpharmacologic interventions. Proc Am Thorac Soc. 2007;4:577–82.CrossRef
25.
go back to reference Smelt AFH, van der Weele GM, Blom JW, Gussekloo J, Assendelft WJJ. How usual is usual care in pragmatic intervention studies in primary care? An overview of recent trials. Br J Gen Pract. 2010;60:e305–18.CrossRef Smelt AFH, van der Weele GM, Blom JW, Gussekloo J, Assendelft WJJ. How usual is usual care in pragmatic intervention studies in primary care? An overview of recent trials. Br J Gen Pract. 2010;60:e305–18.CrossRef
26.
go back to reference Symonds T, Perelman M, Althof S, Giuliano F, Martin M, Abraham L, et al. Further evidence of the reliability and validity of the premature ejaculation diagnostic tool. Int J Impot Res. 2007;19:521–5.CrossRef Symonds T, Perelman M, Althof S, Giuliano F, Martin M, Abraham L, et al. Further evidence of the reliability and validity of the premature ejaculation diagnostic tool. Int J Impot Res. 2007;19:521–5.CrossRef
27.
go back to reference Symonds T, Perelman MA, Althof S, Giuliano F, Martin M, May K, et al. Development and validation of a premature ejaculation diagnostic tool. Eur Urol. 2007;52:565–73.CrossRef Symonds T, Perelman MA, Althof S, Giuliano F, Martin M, May K, et al. Development and validation of a premature ejaculation diagnostic tool. Eur Urol. 2007;52:565–73.CrossRef
28.
go back to reference Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE, et al. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project International Quality of Life Assessment. J Clin Epidemiol. 1998;51:1171–8 Available from: http://www.ncbi.nlm.nih.gov/pubmed/9817135.CrossRef Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE, et al. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project International Quality of Life Assessment. J Clin Epidemiol. 1998;51:1171–8 Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​9817135.CrossRef
31.
go back to reference Klar N, Darlington G. Methods for modelling change in cluster randomization trials. Stat Med. 2004;23:2341–57.CrossRef Klar N, Darlington G. Methods for modelling change in cluster randomization trials. Stat Med. 2004;23:2341–57.CrossRef
32.
go back to reference Macdowall W, Parker R, Nanchahal K, Ford C, Lowbury R, Robinson A, et al. ‘Talking of Sex’: developing and piloting a sexual health communication tool for use in primary care. Patient Educ Couns. 2010;81:332–7.CrossRef Macdowall W, Parker R, Nanchahal K, Ford C, Lowbury R, Robinson A, et al. ‘Talking of Sex’: developing and piloting a sexual health communication tool for use in primary care. Patient Educ Couns. 2010;81:332–7.CrossRef
Metadata
Title
Premature ejaculation in primary care: communication strategies versus usual care for male patients consulting for a sexual, urogenital or psychological reason – GET UP: study protocol for a cluster randomised controlled trial
Authors
Marie Barais
Hélène Vaillant Roussel
David Costa
Jérémy Derriennic
Bruno Pereira
Sébastien Cadier
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Trials / Issue 1/2018
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-018-2947-2

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