Researchers studied communication about erectile dysfunction (ED) between doctors and 120 Asian male patients with diabetes in a primary care clinic in Kedah, Malaysia. At the outset of the study, all participating physicians received a brief introduction to the fundamentals of ED treatment. Prior to a regular consultation, 60 men (the intervention group) were given a simple prompt sheet on which they could indicate whether they wanted to discuss, or were already discussing, ED with their doctor; physicians in the intervention group were provided with a knowledge translation flipchart developed by the researchers to assist with ED discussion. The flipchart featured concise, plain-language text and colorful illustrations, presented on paired patient- and physician-facing panels. Neither patients nor doctors in the control group received materials to facilitate discussion. Following consultation, all 120 men in the study completed a survey providing demographic information, an ED diagnostic sheet (the 5-item International Index of Erectile Function, or IIEF-5), and questions about any discussion of ED with their physician.
About two-thirds of the intervention group discussed ED-related issues with their physician, compared with 8.3% of the control group. ED medications were prescribed to 57.5% of subjects in the intervention group, but to none in the control group. Physicians used the flipchart in 82.5% of intervention group consultations, and all patients with whom the flipchart was used reported that they were satisfied with their consultations.
What We Know: ED is a common sexual dysfunction worldwide and often affects men with other serious health issues, including type 2 diabetes mellitus (T2DM). Nevertheless, ED is frequently underdiagnosed and undertreated due to communication barriers between patients, who might face embarrassment about discussing sexual health, and physicians, who might not be knowledgeable about ED. Further, Asian men tend to be more conservative about sexuality—and, by extension, addressing sexual health with their doctors—than European men, despite experiencing higher rates of sexual dysfunction.
What This Study Adds: This study suggests that, for Asian men who view ED as a taboo subject, the use of both doctor- and patient-oriented materials may encourage conversations about and treatment of ED. Usage of the flipchart created for this study may improve patients’ overall satisfaction with ED consultation in this cultural context. This type of intervention could improve diagnosis and treatment of ED elsewhere if the knowledge translation tools are adapted to respond to diverse cultures’ attitudes toward ED and sexual health more broadly.
Improving Erectile Dysfunction Management Among Asian Men With Diabetes Using the Knowledge Translation Intervention
Saharuddin Ahmad, MD, MMed, et al
Department of Family Medicine, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
Pre-embargo article link (Link expires at 5 p.m. EDT Nov. 27, 2023)
Journal
The Annals of Family Medicine