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在初级保健中谈论早泄:GET UP整群随机对照试验

Talking about premature ejaculation in primary care: the GET UP cluster randomised controlled trial.

作者信息

Barais Marie, Costa Marine, Montalvo Camille, Rannou Vincent, Vaillant-Roussel Hélène, Costa David, Cadier Sébastien, Pereira Bruno

机构信息

Department of General Practice, Université de Bretagne Occidentale, Brest, France

Department of General Practice, Faculty of Medicine, Clermont Auvergne University, Clermont-Ferrand, France.

出版信息

BJGP Open. 2022 Aug 30;6(2). doi: 10.3399/BJGPO.2021.0168. Print 2022 Jun.

Abstract

BACKGROUND

Premature ejaculation (PE) is the most common sexual dysfunction in males. A previous qualitative study identified six communication strategies described by GPs to tackle this topic during consultations.

AIM

To determine whether these six strategies are more effective than usual care for promoting discussion about PE between patients and their GPs.

DESIGN AND SETTING

Cluster randomised controlled trial, stratified in four French regions, with an intervention group (GPs who received a training session on the six communication strategies) and a control group (routine medical care). Participants were males aged 18-80 years consulting for a sexual, urogenital, or psychological reason.

METHOD

The efficacy of the training session in communication skills, compared with usual care, was evaluated by determining the percentage of patients who discussed PE with their GP (primary outcome). The percentage of enrolled patients with PE was calculated using a cut-off score >9 of the premature ejaculation diagnostic tool (PEDT) completed by the enrolled patients at Week 4 after the consultation. The quality-of-life changes were evaluated as the SF-12 scale score difference between baseline and Week 4 post-consultation.

RESULTS

In total, 130 patients were included by 32 GPs ( = 16 in the intervention and = 16 in the control group). The percentage of patients who discussed PE was higher in the intervention group than in the control group (42.0% versus 4.9%, absolute difference = 37.1%; 95% confidence intervals [CI] = 24% to 50%, <0.001).

CONCLUSION

Training GPs in communication strategies about PE improves its detection.

摘要

背景

早泄(PE)是男性中最常见的性功能障碍。先前的一项定性研究确定了全科医生(GPs)在会诊期间用于处理该主题的六种沟通策略。

目的

确定这六种策略在促进患者与其全科医生之间关于早泄的讨论方面是否比常规护理更有效。

设计与设置

整群随机对照试验,在法国四个地区进行分层,分为干预组(接受了关于六种沟通策略培训课程的全科医生)和对照组(常规医疗护理)。参与者为年龄在18 - 80岁之间因性、泌尿生殖或心理原因前来咨询的男性。

方法

通过确定与全科医生讨论早泄的患者百分比(主要结局),评估沟通技巧培训课程与常规护理相比的效果。使用入组患者在会诊后第4周完成的早泄诊断工具(PEDT)得分>9作为临界值来计算入组的早泄患者百分比。生活质量变化通过会诊前基线与会诊后第4周之间的SF - 12量表得分差异进行评估。

结果

共有32名全科医生纳入了130名患者(干预组 = 16名,对照组 = 16名)。干预组中讨论早泄的患者百分比高于对照组(42.0%对4.9%,绝对差异 = 37.1%;95%置信区间[CI] = 24%至50%,P<0.001)。

结论

对全科医生进行关于早泄的沟通策略培训可提高其对早泄的检出率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a40/9447320/5887bcb6a2c0/bjgpopen-6-0168-f1.jpg

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