Epidemiology and Treatment Barriers of Patients With Erectile Dysfunction Using an Online Prescription Platform: A Cross-Sectional Study

Abstract

Introduction: Erectile dysfunction (ED) is a highly common sexual dysfunction of men but often undertreated as patients experience high treatment barriers.

Aim: The aims of this study were to characterize patients with ED using an online prescription platforms (OPPs) and determine treatment barriers that might prevent patients from seeking care in conventional health care settings.

Methods: Data from a German OPP were retrospectively analyzed with focus on patients suffering from ED with at least one online prescription of phosphodiesterase-5 (PDE5) inhibitors between May 2019 and November 2019. In addition, a voluntary questionnaire was used to assess additional social features and prior treatment barriers.

Main outcome measure: The main outcome measures were the epidemiological data, prescription metadata, and follow-up questionnaires.

Results: A total of 11,456 male patients received prescriptions via the OPP (mean age: 49 years [95% CI 46.92-47.45]). Patients lived mainly in rural areas (69%) and frequently sought prescriptions outside the average office times of German urologists (49%). From all patients that responded to a follow-up questionnaire (n = 242), the majority were employed full-time (81%), married (50%), and native German (94%); 63.5% had not used PDE5 inhibitors before. From all repeat users, 41% had received them from unreliable sources. Reasons to seek treatment via the OPP were convenience (48%), shame (23%), and lack of discretion (13%).

Conclusion: In this first study, to epidemiologically characterize ED patients of an OPP, it was confirmed that inconvenience is a treatment barrier, along with shame and perceived lack of discretion. This is the first evidence that OPPs reduce treatment barriers and ease access for patients to the medical system. Rodler S, von Büren J, Buchner A, et al. Epidemiology and Treatment Barriers of Patients With Erectile Dysfunction Using an Online Prescription Platform: A Cross-Sectional Study. Sex Med 2020;8:370-377.

Keywords: Erectile dysfunction; Online prescription platform; Telemedicine; Treatment barrier.

Figure 1

Prescription volume by daytime and weekday. (A) The average prescription volume (n = 11,465) was analyzed by hours. Daytime was defined as the time between 8 and 17 (black), approximating the opening hours of urologists and pharmacies. (B) Prescription volumes (n = 11,465) were analyzed by weekday. Monday to Friday were defined as weekdays (black), referring to the opening days of urologists in Germany.

Figure 2

Previous prescription and source of potency drugs. (A) Patients who agreed to answer the follow-up questionnaire (n = 242) were asked for their previous usage of potency drugs. Answer options were limited to either “never” (black) or previous use (white). When patients stated previous use, they could choose between “irregular” or “frequent” use. (B) All patients who have used potency drugs before (n = 92) were selected and asked for the primary source of their prior potency drug prescription.

Figure 3

Rationale and referral for online prescription of PDE5 inhibitors. (A) Patients (n = 242) were asked where they have heard about the analyzed online prescription platform for the first time. Response options included TV advertising (TV), Google search engine advertisement (Google), online articles about, for example, erectile dysfunction treatment (Online media) and friends as well as other sources. (B) Patients (n = 152) were asked for their primary reason to use an online prescription platform to identify potential treatment barriers in conventional prescription settings.