Safety of Prescribing PDE-5 Inhibitors via e-Medicine vs Traditional Medicine

Munger, Mark A.; Stoddard, Gregory J.; Wenner, Allen R.; Bachman, John W.; Jurige, John H.; Poe, Laura; Baker, Diana L.
August 2008
Mayo Clinic Proceedings;Aug2008, Vol. 83 Issue 8, p890
Academic Journal
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-medlcine clients (mean ± SD age, 47±11 years; hypertension, 60%; type 2 diabetes meilitus, 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, crosssectional 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 éounseling showed superiority of the e-medicine system. Standard diagnostic questions were required for e-mediclne 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.


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