Pd28-04 Evaluation of Online Telehealth Platforms for Direct-to-consumer Treatment of Erectile Dysfunction
Year: 2020
Type: article
Abstract: You have accessJournal of UrologySexual Function/Dysfunction: Evaluation I (PD28)1 Apr 2020PD28-04 EVALUATION OF ONLINE TELEHEALTH PLATFORMS FOR DIRECT-TO-CONSUMER TREATMENT OF ERECTILE DYSFUNCTION Walter Hsiang*, Eric Elftmann, Stanton Honig, and Michael Leapman Walter Hsiang*Walter Hsiang* More articles by this author , Eric ElftmannEric Elftmann More articles by this author , Stanton HonigStanton Honig More articles by this author , and Michael LeapmanMichael Leapman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000892.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Several online telehealth services have emerged offering direct-to-consumer evaluation and treatment of several men’s health conditions including sexual dysfunction and hair loss. Although these platforms offer rapid, discreet, and affordable venues for healthcare, less is known about their medical evaluation process and criteria for drug prescription. We assessed the agreement between the evaluation questions used by leading telehealth services and major clinical practice guidelines. METHODS: We performed a web search to identify online telehealth platforms that marketed direct-to-consumer prescription of phosphodiesterase-5 (PDE5) inhibitors for treatment of erectile dysfunction (ED) (N=8). After excluding services that did not specialize in men’s health (N=6), we identified two online services (Roman ® and hims ®). Two researchers compiled the online questionnaires administered to men seeking PDE5 inhibitors for ED both prior to and after prescription. We compared the questionnaires with the American Urological Association’s 2018 Erectile Dysfunction guidelines. Ten board-certified urologists (seven specialized and three non-specialized in sexual medicine) were asked to rate, on a five-item Likert scale using an online survey (1=not addressed at all; 5=well-addressed), how well the questions addressed distinct guidelines pertaining to the medical management of ED. We calculated average ratings for each question. Additionally, we calculated Krippendorff’s alpha statistic to measure the agreement among raters. RESULTS: Deviations from the AUA guidelines were noted in questions relating to the absence of a validated questionnaire to assess ED severity and physical exam. Information was provided prior to a prescription, suggesting that ED was a marker for underlying heart disease. We identified 11 items within the AUA ED guidelines that directly pertained to the medical management of ED. Mean scores among all questions were 2.4 (SD=0.5) for Roman, and 2.2 for hims (SD=0.6). The Krippendorff’s alpha was low for both platforms (0.09 and 0.06 for Roman and Hims, respectively). Inter-rater variation was similarly low for both sexual medicine and non-sexual medicine specialized urologists. CONCLUSIONS: Online telehealth platforms have rapidly emerged as major purveyors of men’s health care. We found that although the recommended medical history and counseling included elements advocated by the AUA’s practice guidelines, urologists reported, with low inter-rater reliability, only modest agreement with the practice guidelines for ED. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e613-e613 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Walter Hsiang* More articles by this author Eric Elftmann More articles by this author Stanton Honig More articles by this author Michael Leapman More articles by this author Expand All Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3021571403