Stinting on sildenafil supply can prove costly

Hackett, Geoffrey

doi:10.1002/tre.525

Cited by 1 publication

(2 citation statements)

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“…NHS prescribing of PDE5is is often limited to once-weekly use, which may not adequately support men’s needs or specialist sexual rehabilitation programme aims 46. ‘Stinting’ on effective treatments such as PDE5is can be a false economy, potentially resulting in treatment failure and the need for expensive secondary referrals 23 24. It is hoped that the recent availability of reduced cost generic sildenafil and tadalafil, and the lifting of restrictions on its daily use, will allow more men with ED to receive early treatment.…”

Section: Discussionmentioning

confidence: 99%

“…A wide range of treatments are available for the management of ED, including oral phosphodiesterase type 5 inhibitors (PDE5is), intracavernosal injections (ICI), intraurethral suppositories or ointment (alprostadil), vacuum erection devices (VED), and penile implants 10 11 20. Nevertheless, ED remains an under-reported and often undertreated condition 21–24. The LAPCD study reported that only 44% of men were offered intervention(s) to help with sexual function, such as medications, devices or specialist services 16.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Management of erectile dysfunction after prostate cancer treatment: cross-sectional surveys of the perceptions and experiences of patients and healthcare professionals in the UK

et al. 2019

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ObjectivesErectile dysfunction (ED) is known to be a common consequence of radical treatment for prostate cancer (PCa) but is often under-reported and undertreated. This study aimed to explore how ED in patients with PCa is managed in real-life clinical practice, from the perspective of patients and healthcare professionals (HCPs).Design and settingThis is a UK-wide cross-sectional survey of men with ED after treatment for PCa which covered assessment and discussion of erectile function, provision of supportive care and satisfaction with management. Parallel surveys of primary and secondary HCPs were also conducted.ResultsResponses were received from 546 men with ED after PCa treatment, 167 primary (general practitioners and practice nurses) and 94 secondary care HCPs (urologists and urology clinical nurse specialists). Survey findings revealed inadequate management of ED in primary care, particularly underprescribing of effective management options. A fifth of men (21%) were not offered any ED management, and a similar proportion (23%) were not satisfied with the way HCPs addressed their ED concerns. There was poor communication between HCPs and men, including failure to initiate discussions about ED and/or involve partners, with 12% of men not told that ED was a risk factor of PCa treatment. These issues seemed to reflect poor access to effective ED management or services and lack of primary HCP confidence in managing ED, as well as confusion over the roles and responsibilities among both HCPs and men.ConclusionsThis study confirms the need for better support for men from HCPs and more tailored and timely access to effective ED management after treatment for PCa. A clearly defined pathway is required for the discussion and management of ED, starting from the planning stage of PCa treatment. Improved adherence to ED management guidelines and better education and training for primary care HCPs are areas of priority.

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Section: Discussionmentioning

confidence: 99%