Abstract
BackgroundPremature ejaculation (PE) is the most common sexual dysfunction among men. According to patients, the general practitioner (GP) is the appropriate professional with whom to discuss this issue. However, few patients receive the medical help needed because GPs find it difficult to talk to their patients about sex. A previous qualitative study provided six strategies described by GPs who had tackled the topic during consultation. A pilot study showed that using one of these strategies after a training course led to an increase in the rate of consultations where the topic was raised: an increase from 6.6 to 30.8%. The aim of this study is to compare whether training in communication skills with these six strategies is more effective than usual care on the incidence of patients bringing up the topic of PE with their GP.MethodsA cluster randomised controlled trial, stratified over four areas comparing an intervention group, which will receive the six strategies training session, and a control group, which ensures routine medical care. The primary outcome is to investigate the efficacy of a training in communication skills directed towards this pathology, compared with usual care procedures, on the incidence of patients bringing up the topic of PE with their GP. The secondary objective relates to the variation in the quality of life of patients after having recently addressed the topic of PE. Quality of life will be evaluated using the SF-12 health scale, with scoring filled in by the patient immediately after the consultation and 4 weeks later. The patients suffering from PE will be identified if their score is higher than 9 on the Premature Ejaculation Diagnostic Tool filled in 4 weeks after the consultation. The number of patients necessary to highlight a significant difference between the two groups from 5 to 20% is 101. Therefore, a total of 600 patients is expected, 300 in each arm (40 GPs, 15 patients per GP; risk α = 5%; power = 90%; intra-cluster correlation coefficient ρ = 0.2; Hawthorne effect = 15%; lost-to-follow-up rates for GPs = 10% and for patients = 20%).DiscussionThe implication for practice is the improvement in the quality of patient-centred care within a topic area which encompasses almost 30% of male sex-related complaints.Trial registrationClinicalTrials.gov, ID: NCT02378779. Registered on 3 February 2015.
Highlights
Premature ejaculation (PE) is the most common sexual dysfunction among men
The main aim of this study is to investigate whether training in communication skills with these six strategies is more effective than usual care on the incidence of patients bringing up the topic of PE with their general practitioner (GP)
Six different strategies for tackling the subject were brought to light after a qualitative phase with GPs was compared with usual care procedures in primary health care
Summary
Premature ejaculation (PE) is the most common sexual dysfunction among men. According to patients, the general practitioner (GP) is the appropriate professional with whom to discuss this issue. A previous qualitative study provided six strategies described by GPs who had tackled the topic during consultation. The premature-like ejaculatory dysfunction corresponds to the patient’s distorted perception of time before ejaculation: the patient is convinced that he is suffering from PE his Intravaginal Ejaculation Latency Time (IELT) is more than 1 min. While the prevalence, according to men’s self-reports, is 30%, the rate drops to 3% when the time factor is considered in isolation [5]. This statement illustrates the incompatibility between the academic definition and the actual complaints from patients
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