The Causes of Patient Dropout From Penile Self-Injection Therapy for Impotence

Mulhall, John P.; Jahoda, Andrew E.; Cairney, Michael; Goldstein, Bryan; LEITZES, ROD; WOODS, JORDAN; Payton, Terry; Krane, Robert J.; Goldstein, Irwin

doi:10.1016/s0022-5347(05)68269-9

Cited by 76 publications

(29 citation statements)

References 16 publications

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“…We conservatively assumed that theutility gain of sildenafil and papaverine-phentolamine injections would be the same. Given the low acceptability of injection therapy, 9 10 this assumption probably overestimates the benefits of injection therapy.…”

Section: Participants and Methodsmentioning

confidence: 99%

Cost utility analysis of sildenafil compared with papaverine-phentolamine injections

Stolk

Busschbach²,

Caffa³

et al. 2000

BMJ

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Objective To compare the cost effectiveness of sildenafil and papaverine-phentolamine injections for treating erectile dysfunction. Design Cost utility analysis comparing treatment with sildenafil (allowing a switch to injection therapy) and treatment with papaverine-phentolamine (no switch allowed). Costs and effects were estimated from the societal perspective. Using time trade-off, a sample of the general public (n = 169) valued health states relating to erectile dysfunction. These values were used to estimated health related quality of life by converting the clinical outcomes of a trial into quality adjusted life years (QALYs). Participants 169 residents of Rotterdam. Main outcome measures Cost per quality adjusted life year.

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Section: Participants and Methodsmentioning

confidence: 99%

Cost utility analysis of sildenafil compared with papaverine-phentolamine injections

Stolk

Busschbach²,

Caffa³

et al. 2000

BMJ

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“…Recent data on ED treatment outcome have shown that many patients discontinue treatment, despite the availability of efficacious pharmacotherapies. Drop-out rates as high as 50% have been described in several studies [89][90][91]. Many issues, other than efficacy or safety, have implications in drop-outs.…”

Section: Future Directionsmentioning

confidence: 99%

Phosphodiesterase Type 5 Inhibitors: Unmet Needs

Hatzimouratidis¹,

2009

CPD

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Erectile dysfunction (ED) has been revolutionized during the last two decades, as several treatment options are available today. Phosphodiesterase type 5 (PDE5) inhibitors (sildenafil, tadalafil, vardenafil) are currently the first choice treatment option for ED by most physicians and patients due to their high efficacy rates and favourable safety profiles. Despite the fact that more than 50 million ED patients have been treated successfully worldwide with PDE5i several issues remain to be addressed. Patients with severe neurologic damage, diabetes mellitus, or severe vascular disease may be resistant to PDE5i. Inappropriate instructions, lack of follow-up and lack of patient-centered care models have been identified as main reasons for "nonresponse", leading to drop-out rates of even > 50%. Preservation of corporal smooth muscle with chronic administration of PDE5i has been reported and there is a substantial body of evidence for beneficial effects of these drugs on endothelium and cardiovascular function. Finally, improvement of lower urinary symptoms after PDE5i administration has been reported and a possible role on treatment of premature ejaculation has been proposed. Many new PDE5i are candidates to enter the market in the forthcoming years. However, pharmacokinetic differences should be obvious to consider a truly better option for patients. Patients must be aware of all treatment options since no ideal treatment exists and physicians must offer personalized medicine to their patients in the future. The development and adaptation of a patient-centered care model in sexual medicine will increase efficacy and safety of current and future treatments.

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“…De plus, les patients autant que leur partenaire préfèrent nettement les formes de thérapeutique les moins invasives [14] et de nombreuses partenaires féminines craignent que les injections intracaverneuses, par exemple, puissent blesser le patient et entraîner des complications [15]. C'est une des raisons pour lesquelles on rencontre un nombre relativement élevé de patients arrêtant leur traitement.…”

Section: La Qualité De Vie Des Partenaires Fémininesunclassified