Evaluation of current errors within the administration of phosphodiesterase-5 inhibitors after more than 10 years of use

Objective: To detect current errors within the administration of phosphodiesterase type 5 inhibitors (PDE5is) and evaluate and elucidate what percentage of patients could be recovered for oral therapy with different subtypes of PDE5is through a re-education program.

Methods: Two hundred fifty patients remitted to the andrology unit were prospectively analyzed. Patients' chief complaint was erectile dysfunction despite treatment with PDE5i. The International Index of Erectile Function was used to measure erectile function. A structured interview was developed to evaluate the most frequent errors within the administration of PDE5is. A re-education program was offered to patients with incomplete or incorrect use of PDE5is according to the structured interview, classifying them into true nonresponders or false nonresponders. Finally, the percentage of patients who could be recovered for oral therapy with other PDE5is was analyzed.

Results: A total of 172 patients (69%) presented some error within drug administration. The most common error was not trying >1 PDE5i (41%). A re-education program was offered to these nonresponders, and 115 (66.9%) accepted. Up to 27 (23.5%) did not respond to the re-education program and were classified as true nonresponders, whereas 88 (76.5%) had a positive response to treatment and were thus included in the false nonresponder group.

Conclusion: Two-thirds of patients remitted to our andrology unit and cataloged as nonresponders were in fact using PDE5i in suboptimal conditions. Offering patients more accurate information provided almost 76% with good results using PDE5is and could therefore be successfully treated with these drugs.