(204) Predictors of Non-Prescription PDE-5 Inhibitor Use in Adult Men - Results of a Community-Based Survey

Abstract

Abstract Introduction PDE-5 inhibitors have long been the mainstay of medical management for erectile dysfunction but do carry the risk for potentially significant side effects, particularly when combined with other medications. The increased availability of these medicines from sources outside of a physician’s office may present risks to patients due to incomplete counseling or medication reconciliation and may also expose individuals to counterfeit medication. Prior work has shown PDE-5i inhibitors obtained online are frequently counterfeit with inaccurate dosing of the active ingredient. Factors associated with non-prescription PDE-5 inhibitor use remain incompletely characterized. Objective We sought to characterize associations of demographic variables, sexual function, and sexual orientation with PDE-5i obtained from non-prescription means. Methods Males 18 years and older were recruited through a national registry of volunteers (Research Match) to participate in an online survey. We assessed PDE-5 inhibitor use and the source of this medication within the last year. Validated scores for erectile function (IIEF-5) and ejaculatory function (PEDT) were obtained in addition to demographic data and sexual partner information. Univariable and multivariable logistic regression was performed to identify associations with obtaining PDE-5 inhibitors from a non-prescription source. Results Of the 1033 men who completed the survey, 348 reported using PDE-5 inhibitors in the past year (Table 1). Of this cohort, 88 (25.1%) reported obtaining PDE-5 inhibitors from an online source, purchase from non-pharmacy source, or obtained from family or friends. Men obtaining PDE-5i outside a physician’s office tended to be younger (median age 51.5 vs. 62, p<0.001) than those obtaining it with a standard prescription. Sexual function characteristics including IIEF and PEDT scores were similar between groups. Men who have sex with men (MSM) were nearly twice as likely to have obtained PDE-5i from a non-prescription or online source (37.3 vs. 22.5%, P=0.018). Married men were less likely than single men to purchase PDE-5i from a nonprescription source (22.3 vs. 35.9%, P=0.017On multivariable analysis, only younger age was associated with increased odds of obtaining PDE-5i from an online or non-prescription source (OR 0.97, 0.95-0.98, P<0.001; Table 2). Conclusions In this large, community-based study of adult men, we found that a quarter of PDE-5i users had obtained medication from either an online source or from family or friends. Furthermore, we found that younger men and men who have sex with men were more likely to obtain these medicines from alternative sources. While these medicines are typically well tolerated, medication obtained from unreliable sources is more likely to be counterfeit and may place individuals at higher risk for adverse events. Disclosure No