The Brief Sexual Symptom Checklist as a Screening Tool for Sex-Related Problems in the Primary Care Setting: Focus on Erectile Dysfunction

Practices and knowledge of general practitioners on erectile dysfunction: A practice survey

INTRODUCTION

Erectile dysfunction (ED) is a common and underestimated sexual disorder. This sexual concern, which should raise the suspicion of an underlying coronary artery disease, is rarely broached by general practitioners (GPs). The aim of this work was to establish an inventory of the practices and knowledge of general practitioners when faced with a case of ED.

METHODS

This survey is a descriptive cross-sectional epidemiological study targeting GPs' practice. Answers were collected through a self-questionnaire, "KIKI SAIT?", online that explored: demographic data, level of practice and theoretical knowledge regarding ED.

RESULTS

One hundred and seventy-seven GPs took part in this study. Regarding their practice, 80.2% of doctors expected the patient to bring up the subject. Few clinicians managed ED according to recommendations of the French Association of Urology. More than 30% referred the patient to a urologist, cardiologist or endocrinologist. In total, 57.6% of practitioners prescribed a phosphodiesterase 5 inhibitor (PDE5I) as first-line treatment. Regarding their knowledge, 67.8% of doctors considered their level of knowledge about PDE5I to be poor, 96.6% about intracavernosal injections, 88.7% about vacuum devices and 91% about penis rings. The main obstacle retained was the lack of medical knowledge (71.2%). Clinicians who rarely consulted for ED were less confident in explaining possible treatments (25/63 versus 18/113, P<0.001).

CONCLUSION

Strengthening initial training and providing a practical algorithm for the management of ED could be useful to help general practitioners detect ED, which could be a sentinel of coronary heart disease.

LEVEL OF EVIDENCE: 4

Let's talk about sexuality - A web-based survey of self-reported competence in sexual problems among obstetrician-gynecologists in Finland

INTRODUCTION

Sexual health is an important aspect of quality of life, yet both healthcare professionals and patients might hesitate to bring up the topic during appointments. Our study investigated obstetrician-gynecologists' (OB/GYNs') self-reported competences in discussing and treating sexual problems, as well as the barriers to bringing up the subject. An additional aim was to evaluate the need for continuing education in sexual medicine.

MATERIAL AND METHODS

A web-based questionnaire was sent to the members of The Finnish Society of Obstetrics and Gynecology (n = 1212). The survey was completed by 328 respondents (275 specialists and 53 OB/GYN residents). Their background information (gender, age, education, occupational status, daily number of patients, and daily number of patients with sexual health issues) was assessed. The questionnaire included four fields: (A) self-reported competence in discussing and treating patients with sexual problems (three questions), (B) the barriers to bringing up sexual problems with patients (nine questions), (C) the source of education in sexual medicine (two questions), and (D) the need for education in sexual medicine (two questions).

RESULTS

Most of the OB/GYNs self-reported their competence to be good in discussing sexual problems, but poor in treating patients' sexual problems. The male OB/GYNs reported better competence than did the females. Several barriers were identified-most frequently, "shortness of the appointment time" (76%), "lack of knowledge about sexual medicine" (75%), and "lack of experience with sexual medicine" (74%). Older OB/GYNs and male OB/GYNs reported fewer barriers. The majority of the respondents considered their previous education in sexual medicine to be insufficient, especially in medical school (95%), but also in residency (83%), and they reported a need for additional education.

CONCLUSIONS

Our study indicated several barriers that hindered OB/GYNs from assessing sexual problems during appointments. Although OB/GYNs reported a good competence in discussing sexual problems, they reported a poor competence in treating them. Their previous education in sexual medicine was rated as insufficient, and continuing education was desired. The information provided by our study can be used for improving and organizing education in sexual medicine, which is crucial for diminishing the barriers to discussing and treating sexual problems.

Cohort profile: Health in Central Denmark (HICD) cohort - a register-based questionnaire survey on diabetes and related complications in the Central Denmark Region

PURPOSE

The Health in Central Denmark (HICD) cohort is a newly established cohort built on extensive questionnaire data linked with laboratory data and Danish national health and administrative registries. The aim is to establish an extensive resource for (1) gaining knowledge on patient-related topics and experiences that are not measured objectively at clinical health examinations and (2) long-term follow-up studies of inequality in diabetes and diabetes-related complications.

PARTICIPANTS

A total of 1.3 million inhabitants reside in the Central Denmark Region. Using register data and a prespecified diabetes classification algorithm, we identified 45 507 persons aged 18-75 years with prevalent diabetes on 31 December 2018 and a group without diabetes of equal size matched by sex, age and municipality. A 90-item questionnaire was distributed to eligible members of this cohort on 18 November 2020 (estimated time required for completion: 15-20 min).

FINDINGS TO DATE

We invited 90 854 persons to take part in the survey, of whom 51 854 answered the questionnaire (57.1%). Among these respondents, 2,832 persons had type 1 diabetes (55.9%), 21,140 persons had type 2 diabetes (53.2%), while 27,892 persons were part of the matched group without diabetes (60.4%). In addition to questionnaire data, the cohort is linked to nationwide registries that provide extensive data on hospital diagnoses and procedures, medication use and socioeconomic status decades before enrolment while laboratory registries has provided repeated measures of biochemical markers, for example, lipids, albuminuria and glycated haemoglobin up to 10 years before enrolment.

FUTURE PLANS

The HICD will serve as an extensive resource for studies on patient-related information and inequality in type 1 diabetes and type 2 diabetes. Follow-up is planned to continue for at least 10 years and detailed follow-up questionnaires, including new topics, are planned to be distributed during this period, while registry data are planned to be updated every second year.