Decision tree analyses of key patient characteristics in Middle Eastern/North African and Latin American men treated with long-acting and short-acting PDE5 inhibitors for erectile dysfunction.
BACKGROUND
Phosphodiesterase type 5 (PDE5) inhibitors have discontinuation rates as high as 60% in men with erectile dysfunction. Treatment satisfaction has been significantly associated with treatment continuation. Understanding key characteristics in terms of treatment preference, relationship, and lifestyle issues could provide direction on how to improve compliance with PDE5 inhibitor treatment globally.


OBJECTIVE
The objective was to identify subgroups of interest in the pooled database of two observational studies conducted in Latin America (LA) and Middle East/North Africa (MENA) exploring patient characteristics and prescription of either a long- or short-acting PDE5 inhibitor at baseline.


METHODS
Two identical prospective, non-interventional, observational, studies in MENA (N = 493) and LA (N = 511) treated men with an 'on demand' (pro re nata, PRN) PDE5 inhibitor (sildenafil, tadalafil, vardenafil, or lodenafil) during 6 months. In this post-hoc meta-analysis of two observational studies with equal design, pooled data were analyzed to determine patient characteristics and PDE5 inhibitor prescribed/used most likely to be associated with patient expectations, satisfaction, self-esteem, and patient-partner relationships. Decision tree analyses, with and without weighting, were used to identify and describe key features.


RESULTS
In each analysis of patient expectations, patient-partner relationship, and self-esteem, we describe the two major subgroups at baseline for each decision tree. Analyses of patient expectations and sexual self-esteem revealed that patients prescribed long-acting PDE5 inhibitors (59%) highlighted the importance of treatment effect duration, second to partner satisfaction with treatment, while patients prescribed short-acting PDE5 inhibitors (32%) placed less importance on treatment effect duration but considerable importance on treatment effect lasting until intercourse completion. Further insights regarding patients, partner relationship characteristics, and treatment expectations were identified.


CONCLUSION
Our analyses have described key characteristics, such as self- and partner perceptions, sexual attitudes, and treatment expectations in relation to the patients' country and prescribed treatment, which might guide treatment decisions in MENA and LA men with ED.
['Rubio-Aurioles|Eusebio|E|', 'El-Meliegy|Amr|A|', 'Abdulwahed|Samer|S|', 'Henneges|Carsten|C|', 'Sorsaburu|Sebastian|S|', 'Gurbuz|Sirel|S|']
D000328:Adult D000352:Africa, Northern D003663:Decision Trees D003692:Delayed-Action Preparations D007172:Erectile Dysfunction D006801:Humans D007398:Interpersonal Relations D007843:Latin America D008019:Life Style D008297:Male D008875:Middle Aged D008877:Middle East D010349:Patient Compliance D057240:Patient Preference D058986:Phosphodiesterase 5 Inhibitors D010818:Practice Patterns, Physicians' D011446:Prospective Studies D012649:Self Concept D011795:Surveys and Questionnaires D016896:Treatment Outcome
Middle Eastern/North African Latin American PDE5 inhibitor Erectile dysfunction Tadalafil Decision tree analysis