Safety of prescribing PDE-5 inhibitors via e-medicine vs traditional medicine.

Mayo Clin Proc. 2008 Aug;83(8):890-6.
Munger MA, Stoddard GJ, Wenner AR, Bachman JW, Jurige JH, Poe L, Baker DL.

Department of Internal Medicine, Universityof Utah, Salt Lake City 84112-5820, USA. mmunger@hsc.utah.edu

OBJECTIVE: To determine the safety of a US-based, state-regulated Internet system vs a multispecialty primary care system for prescribing phosphodiesterase type 5 (PDE-5) inhibitors for erectile dysfunction. PATIENTS AND METHODS: From January 1, 2001, through December 31, 2005, 500 e-medicine clients (mean+/-SD age, 47+/-11 years; hypertension, 60%; type 2 diabetes mellitus, 2%; mean+/-SD number of medications, 0.4+/-0.8) vs 500 traditional medicine patients (mean+/-SD age, 57+/-12 years; hypertension, 50%; type 2 diabetes mellitus, 23%; mean+/-SD number of medications, 5.1+/-3.1) with erectile dysfunction symptoms were assessed. Noninferiority safety was assessed in this retrospective, cross-sectional study with stratified random sampling by identification of prescribing in the presence of clinically important PDE-5 inhibitor drug interactions with or without high-risk cardiovascular disease, by asking about diagnostic symptoms specific to erectile dysfunction, and by determining frequency of patient counseling. RESULTS: Noninferiority of the e-medicine system was shown for the 6 safety end points, relative to a traditional medicine system. Numbers of inappropriate prescriptions, after correction for disease and medication covariates, did not differ between systems. Medication counseling showed superiority of the e-medicine system. Standard diagnostic questions were required for e-medicine prescribing but were infrequently asked in traditional medicine. CONCLUSION: Safety in prescribing PDE-5 inhibitors for erectile dysfunction was similar between a US-based, state-regulated Internet prescribing system and a multispecialty primary care system.

• Safety of Internet Prescribed Erectile Dysfunction Drugs
• Pharmacokinetics, pharmacodynamics, and efficacy of phosphodiesterase type 5 inhibitors.
• A study of the management of erectile dysfunction in general practice.
• Pharmacotherapy of erectile dysfunction: focus on cardiovascular safety.
• [Advances in studies of Chinese herbs for improving relaxability of corporal smooth muscle]