Faculty of Health and Human Sciences, Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK.
Int J Clin Pract. 2011 Jul;65(7):797-806. doi: 10.1111/j.1742-1241.2011.02693.x.
To determine the rate of newly detected underlying disease in men receiving their first (index) phosphodiesterase type 5 inhibitor (PDE5i) prescription.
This non-interventional, retrospective study used anonymised patient records from UK general practices identified from the THIN database. Records of men aged ≥ 18 years, who received an index PDE5i prescription between January 1999 and June 2008 and with a continuous medical history (≥ 60 months) before the index prescription were included. Primary end-points were the prevalence of underlying disease prior to the index prescription and to establish the detection rate, defined as cumulative incidence of such a diagnosis in the 3 months following the index prescription. Assessments included comparison with age-matched controls, comparison with identical time periods immediately before and 1 year after, index prescription, and changes over time during the study period. Descriptive statistics, analysis of proportions and multivariate logistic regression analysis were used.
Among the 24,708 patients receiving a PDE5i, the prevalence of any underlying diagnosis before the index prescription was 70.23%; prevalence of vasculogenic disease was highest (48.20%). The detection rate of any underlying disease was 11.53%, and again highest for vasculogenic disease (4.07%). Compared with an age-matched control population, the additional detection rate of an unknown underlying disease at PDE5i prescription was 45 for hypertension, 61 for hypercholesterolaemia, 38 for diabetes and 5 for hypogonadism per 10,000 men.
Only a minority of men with erectile dysfunction have a previously undiagnosed important underlying disease that is uncovered at the time of an initial PDE5i prescription by a GP.
确定首次接受磷酸二酯酶 5 抑制剂（PDE5i）处方的男性中新发现的潜在疾病的发生率。
这是一项非干预性、回顾性研究，使用了来自 THIN 数据库的英国普通诊所匿名患者记录。纳入标准为年龄≥18 岁、1999 年 1 月至 2008 年 6 月期间接受首次 PDE5i 处方且在索引处方前有≥60 个月连续病史的男性患者。主要终点为索引处方前潜在疾病的患病率，并确定检测率，定义为索引处方后 3 个月内诊断出此类疾病的累积发生率。评估包括与年龄匹配的对照组进行比较，与索引处方前后相同时间段进行比较，以及在研究期间随时间的变化。采用描述性统计、比例分析和多变量逻辑回归分析。
在接受 PDE5i 的 24708 例患者中，索引处方前任何潜在诊断的患病率为 70.23%；血管源性疾病的患病率最高（48.20%）。任何潜在疾病的检测率为 11.53%，血管源性疾病的检测率最高（4.07%）。与年龄匹配的对照组相比，在 PDE5i 处方时新发现的未知潜在疾病的额外检出率为高血压 45 例/10000 例、高胆固醇血症 61 例/10000 例、糖尿病 38 例/10000 例和低促性腺激素血症 5 例/10000 例。
只有少数勃起功能障碍男性在初始 PDE5i 处方时被全科医生发现了以前未诊断出的重要潜在疾病。
