Increasing access to erectile dysfunction treatment via pharmacies to improve healthcare provider visits and quality of life: Results from a prospective real‐world observational study in the United Kingdom

Abstract

Objectives The Medicines and Healthcare Products Regulatory Agency in the United Kingdom (UK) formally reclassified sildenafil citrate 50 mg tablets as a pharmacy medicine (sildenafil‐P) in 2017 for adult men with erectile dysfunction (ED). A 1‐year prospective real‐world observational study was conducted to track men's health behaviour, particularly their healthcare resource utilisation (HCRU) and quality of life (QoL) before and after the availability of sildenafil‐P. Methods Adult men with ED aged ≥18 years provided data at baseline (prior to launch of sildenafil‐P) and every 3 months after the launch. Demographics, health characteristics, treatments at baseline and HCRU, including number of pharmacist and physician/nurse practitioner visits over time are reported. QoL‐related outcomes were assessed via the Self‐Esteem and Relationship Questionnaire (SEAR), 2‐Item Patient Health Questionnaire and ratings of sexual satisfaction. Generalised linear models were used to assess the association of sildenafil‐P use with total physician/nurse practitioner and pharmacist visits and QoL‐related outcomes at 12 months. Results Overall, 1162 men completed the survey at all 5 time points. The mean ± SD age was 59.02 ± 12.06 years; 55.42% reported having a moderate‐to‐severe ED. Hypertension (37.52%) and hypercholesterolaemia (31.50%) were the most common risk factors for ED. At baseline, 62.99% were not using any ED treatment. After adjusting for baseline visits/other covariates, mean physician/nurse practitioner (3.68 vs 2.87; P = .003) and pharmacist visits for any reason (2.10 vs 1.34; P < .001) at 12 months were significantly higher among sildenafil‐P users than those who never used sildenafil‐P. Sildenafil‐P users also had significantly higher SEAR total and domain (sexual relationship and self‐esteem) scores at 12 months. Conclusion Following the reclassification to a pharmacy medicine in the UK, sildenafil‐P was associated with a higher number of physician/nurse practitioner and pharmacist visits for any reason. Sildenafil‐P use was also associated with better QoL, although group differences were small in magnitude.

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“…Total of 14.8 percent of men in our study cohort reported having received treatment for ED in the last five years. In UK, longitudinal study including 1162 men with mean age of 59 years were conducted and 37 percent of them receive treatment for ED at the baseline of the study, which was more than in our study [13]. More frequent sauna bathers were also more prone to use medication for ED, but there was no statistically significant difference between sauna bathing groups.…”

Quality and readability of online patient information on treatment for erectile dysfunction

“…Width of boxes and error bars scaled to source type frequency. Grand median 34 represented by dashed line…”

“…33 Although descriptions of herbal or over the counter medicines and platelet‐rich plasma injections were infrequent, health professionals must be aware of their limited efficacy and experimental nature to accurately counsel patients who may find this material online. 31 , 34 …”

A web-based survey of UK pharmacists to assess the effectiveness of Viagra Connect® additional risk minimisation measures

“…These observations are consistent with the suggestion that pharmacists see safety as the over-riding concern with supply of over-the-counter or BTC medications [ 15 ]. Indeed, a study suggested that visits to physicians/nurse practitioners significantly increased amongst users following reclassification of Viagra Connect ® [ 16 ]. Our survey also demonstrated that the Viagra Connect ® Pharmacy Checklist was widely utilised (91.9 %), and nearly all pharmacists (96.8 %) found it useful/very useful.…”