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Optimizing treatment outcomes with phosphodiesterase type 5 inhibitors for erectile dysfunction: Opening windows to enhanced sexual function and overall health

Identifieur interne : 001384 ( Istex/Corpus ); précédent : 001383; suivant : 001385

Optimizing treatment outcomes with phosphodiesterase type 5 inhibitors for erectile dysfunction: Opening windows to enhanced sexual function and overall health

Auteurs : Richard Sadovsky ; Gerald B. Brock ; Mikel Gray ; Penny Kaye Jensen ; Stephen W. Gutkin ; Sebastian Sorsaburu

Source :

RBID : ISTEX:56297BF96D594B7B3EA523336A55CF21814D53FA

English descriptors

Abstract

Purpose: Phosphodiesterase type 5 (PDE5) inhibitors have proved to be efficacious, safe, and well tolerated, in clinical trials and practice, for men with erectile dysfunction (ED). However, many patients are not satisfied with treatment and discontinue it prematurely. This review discusses evidence‐based strategies that nurse practitioners (NPs) can use to improve diagnosis of ED, optimize patient outcomes, and identify opportunities to detect other potentially serious comorbid conditions.

Url:
DOI: 10.1111/j.1745-7599.2010.00590.x

Links to Exploration step

ISTEX:56297BF96D594B7B3EA523336A55CF21814D53FA

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<p>Purpose: Phosphodiesterase type 5 (PDE5) inhibitors have proved to be efficacious, safe, and well tolerated, in clinical trials and practice, for men with erectile dysfunction (ED). However, many patients are not satisfied with treatment and discontinue it prematurely. This review discusses evidence‐based strategies that nurse practitioners (NPs) can use to improve diagnosis of ED, optimize patient outcomes, and identify opportunities to detect other potentially serious comorbid conditions.</p>
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<p>Conclusions: Strategies to optimize responses to PDE5 therapy are summarized by the mnemonic “EPOCH”: Evaluating and educating to ensure realistic expectations of therapy; Prescribing a treatment individualized to the couple's needs and preferences; Optimizing drug dose/regimen and revisiting key educational messages at follow‐up visits; Controlling comorbidities via lifestyle counseling, medications, and/or referrals; and Helping patients and their partners to seek other forms of therapy if they have decided not to use a PDE5 inhibitor.</p>
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Richard Sadovsky, MD, MPH, FAAFP, 450 Clarkson Ave., Brooklyn, NY 11203.
Tel: 718‐270‐4096;
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<email>rsadovsk@aol.com</email>
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<familyName>Brock</familyName>
<degrees>MD, FRCSC (Professor of Urology)</degrees>
</personName>
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<givenNames>Mikel</givenNames>
<familyName>Gray</familyName>
<degrees>PhD, FAANP (Professor of Acute & Specialty Care)</degrees>
</personName>
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<unparsedAffiliation>Division of Urology, Faculty of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada</unparsedAffiliation>
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<unparsedAffiliation>Department of Urology, School of Nursing, University of Nursing, Charlottesville, Virginia</unparsedAffiliation>
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<keyword xml:id="k1">Assessment</keyword>
<keyword xml:id="k2">drug therapy</keyword>
<keyword xml:id="k3">erectile dysfunction</keyword>
<keyword xml:id="k4">phosphodiesterases</keyword>
<keyword xml:id="k5">risk factors</keyword>
<keyword xml:id="k6">sexual activity</keyword>
<keyword xml:id="k7">treatment outcomes</keyword>
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<p>
<b>Figure S4</b>
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<p>
<b>Figure S5</b>
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<b>Table S1</b>
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<b>Table S2</b>
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<b>Purpose:</b>
Phosphodiesterase type 5 (PDE5) inhibitors have proved to be efficacious, safe, and well tolerated, in clinical trials and practice, for men with erectile dysfunction (ED). However, many patients are not satisfied with treatment and discontinue it prematurely. This review discusses evidence‐based strategies that nurse practitioners (NPs) can use to improve diagnosis of ED, optimize patient outcomes, and identify opportunities to detect other potentially serious comorbid conditions.</p>
<p>
<b>Data sources:</b>
This article was based on a previously published review, which involved a PubMed–MEDLINE search of the clinical literature from January 1, 1998 (year of sildenafil's approval in many markets), through August 30, 2008 (date of search).</p>
<p>
<b>Conclusions:</b>
Strategies to optimize responses to PDE5 therapy are summarized by the mnemonic “
<b>EPOCH</b>
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<b>E</b>
valuating and
<b>e</b>
ducating to ensure realistic
<b>e</b>
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<b>P</b>
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<b>O</b>
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<b>C</b>
ontrolling
<b>c</b>
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<b>H</b>
elping patients and their partners to seek other forms of therapy if they have decided not to use a PDE5 inhibitor.</p>
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<b>Implications for practice:</b>
The “EPOCH” mnemonic may remind NPs of steps to optimize treatment outcomes with PDE5 inhibitors.</p>
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This article was supported by Eli Lilly and Company, which had a role in data interpretation and the decision to publish the findings.</p>
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<abstract>Purpose: Phosphodiesterase type 5 (PDE5) inhibitors have proved to be efficacious, safe, and well tolerated, in clinical trials and practice, for men with erectile dysfunction (ED). However, many patients are not satisfied with treatment and discontinue it prematurely. This review discusses evidence‐based strategies that nurse practitioners (NPs) can use to improve diagnosis of ED, optimize patient outcomes, and identify opportunities to detect other potentially serious comorbid conditions.</abstract>
<abstract>Data sources: This article was based on a previously published review, which involved a PubMed–MEDLINE search of the clinical literature from January 1, 1998 (year of sildenafil's approval in many markets), through August 30, 2008 (date of search).</abstract>
<abstract>Conclusions: Strategies to optimize responses to PDE5 therapy are summarized by the mnemonic “EPOCH”: Evaluating and educating to ensure realistic expectations of therapy; Prescribing a treatment individualized to the couple's needs and preferences; Optimizing drug dose/regimen and revisiting key educational messages at follow‐up visits; Controlling comorbidities via lifestyle counseling, medications, and/or referrals; and Helping patients and their partners to seek other forms of therapy if they have decided not to use a PDE5 inhibitor.</abstract>
<abstract>Implications for practice: The “EPOCH” mnemonic may remind NPs of steps to optimize treatment outcomes with PDE5 inhibitors.</abstract>
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<topic>sexual activity</topic>
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<note type="content"> Figure S1 Figure S2 Figure S3 Figure S4 Figure S5 Table S1 Table S2 Table S3 Table S4 Figure S1 Figure S2 Figure S3 Figure S4 Figure S5 Table S1 Table S2 Table S3 Table S4 Figure S1 Figure S2 Figure S3 Figure S4 Figure S5 Table S1 Table S2 Table S3 Table S4 Figure S1 Figure S2 Figure S3 Figure S4 Figure S5 Table S1 Table S2 Table S3 Table S4 Figure S1 Figure S2 Figure S3 Figure S4 Figure S5 Table S1 Table S2 Table S3 Table S4 Figure S1 Figure S2 Figure S3 Figure S4 Figure S5 Table S1 Table S2 Table S3 Table S4 Figure S1 Figure S2 Figure S3 Figure S4 Figure S5 Table S1 Table S2 Table S3 Table S4 Figure S1 Figure S2 Figure S3 Figure S4 Figure S5 Table S1 Table S2 Table S3 Table S4 Figure S1 Figure S2 Figure S3 Figure S4 Figure S5 Table S1 Table S2 Table S3 Table S4Supporting Info Item: Supporting info item - </note>
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