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 one-year prospective real-world
observational study was conducted to track men’s health behavior,
particularly their healthcare resource utilization (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 three 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
Self-Esteem and Relationship Questionnaire (SEAR), 2-Item Patient Health
Questionnaire, and ratings of sexual satisfaction. Generalized 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
hypercholesterolemia (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 had significantly higher SEAR total and domain (sexual
relationship and self-esteem) scores at 12 months. Conclusion: Following
the reclassification to 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.