Erektil disfonksiyonu olan hastalarda birinci basamak tedavide Fosfodiesteraz Tip 5 İnhibitörlerinin kullanım yüzdeleri

AMAÇ: Erektil disfonksiyon (ED) tanılı hastalara önerilen fosfodiesteraz tip 5 (PDE5) inhibitörü ilaçların kullanım oranlarını araştırmayı amaçladık. GEREÇ ve YÖNTEMLER: Şubat 2021–Şubat 2022 tarihleri arasında ED nedeniyle ilk kez üroloji polikliniğine başvuran ve 1. basamak tedavi olarak PDE5 inhibitörleri önerilen hastalar çalışmaya dâhil edildi. Spesifik tanı testi gerektiren hastalar, psikososyal inceleme gerektiren hastalar, laboratuvar incelemeleri sonrası altta yatan ve düzeltilmesi gereken endokrinolojik hastalığı bulunan hastalar, kardiyak risk sınıflamasında yüksek risk gruba dahil olan hastalar çalışma dışı bırakıldı. Her hastanın telefon numarası poliklinik değerlendirme notuna eklendi. Hastaların takipleri 1. ayda yapıldı. 1. ay takipleri eğer hasta kontrole gelmişse yüz-yüze, gelmemişse telefon numaraları ile aranarak gerçekleştirildi. BULGULAR: Çalışmaya ilk kez ED nedeniyle başvuran 624 hastadan 1. basamak tedavi olarak PDE5 inhibitörü başlanan 405 hasta dâhil edildi. 1. basamak tedavi olarak PDE5 inhibitörleri kullanımı uygun görülen ve önerilen 405 hastadan 147 (%36,2) tanesinin reçete edilen ilaç veya uygun muadilini aldığı belirlendi. 74 (%18,2) hastanın çeşitli internet siteleri ve televizyon kanalları ile iletişim sağlanan firmalardan sahte ilaç aldıkları görüldü. 31 (%7,6) hastanın ise gingko biloba ve ginseng içerikli bitkisel ürünler kullandığı belirlendi. SONUÇ: Sahte ilaç ve bitkisel ilaçların kullanılmasına yol açan PDE5 inhibitörü ilaçlarının alınamaması durumu, ilaç tedavisine yanıtsızlık ve gereksiz maliyet ile sonuçlanabileceği üroloji hekimlerince iyi bilinmelidir. Gelecekte bu ilaçların belli endikasyonlarda ve belli kurulların onaylandığı raporlarla kullanılması ve geri ödeme kapsamına alınması hastalara ve ülke ekonomisine ciddi katkılar sağlayabilir

The percentages of usage of phosphodiesterase 5 inhibitors for the first-line treatment in patients with erectile dysfunction

OBJECTIVE: We aimed to investigate the rate of use of phosphodiesterase 5 (PDE5) inhibitors drugs recommended for patients with erectile dysfunction (ED). MATERIAL and METHOD: Patients who applied to the urology outpatient clinic for the first time due to ED between February 2021 and February 2022 and were recommended PDE5 inhibitors as firstline therapy were included in the study. Patients requiring a specific diagnostic test, patients requiring psychosocial examination, patients with an underlying endocrinological disease that needed to be corrected after laboratory examinations, and patients included in the high-risk group in cardiac risk classification were excluded from the study. The telephone number of each patient was added to the outpatient evaluation note. The patients were followed up at 1 month. 1st month follow-ups were carried out face-to-face if the patient came for control, or by phone numbers if he did not. RESULTS: Of the 624 patients admitted for the first time with ED, 405 patients who were started on PDE5 inhibitors as first-line therapy were included in the study. It was determined that 147 (36.2%) of the 405 patients who were recommended to use PDE5 inhibitors as first-line treatment were taking the prescribed drug or its appropriate equivalent. It was observed that 74 (18.2%) patients bought counterfeit drugs from companies that were contacted through various websites and television channels. It was determined that 31 (7.6%) patients used herbal products containing gingko biloba and ginseng. CONCLUSION: It should be well known by urology physicians that the inability to take 5 PDE inhibitor drugs, which leads to the use of counterfeit drugs and herbal drugs, may result in unresponsiveness to drug treatment and unnecessary costs. In the future, using these drugs in certain indications and with reports approved by certain committees and including them in the scope of reimbursement will make serious contributions to the patients and the country’s economy.

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