PDE5i as a Cure for Older Adults: An Indicator of Ageist Practices among Physicians
A. Gewirtz- Meydan
The Louis and Gaby Weisfeld School of Social Work, Bar-ilan University, Ramat Gan, Israel
Sex and Couple Therapy Unit, Meir Medical Center, Kfar Saba, Israel
The Louis and Gaby Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
Fulltext (english, pages 77-77).pdf
Objective: The aim of this study is to determine whether physicians have an age bias regarding sexual dysfunction in older vs. younger patients in terms of diagnosis, attributed etiology, proposed treatment and perceived prognosis.
Design and Method: An on-line survey consisting of one of two, randomly administered, case vignettes, which differed only by age (28 or 78). In both cases, the patient was described as suffering from occasional erectile dysfunction with a clear psychosocial indication. A total of 236 physicians responded to the survey. Overall, 110 physicians received an old patient vignette and 126 physicians received a young patient vignette.
Results: Even though both cases presented with a clear psychosocial etiology, the young patient vignette was more likely to be diagnosed with performance anxiety, whereas the old patient vignette with erectile dysfunction. The old patient vignette dysfunction was more likely to be attributed to hormonal changes, health problems and decreased sexual desire. Physicians were more likely to recommend hormonal and PDE5 inhibitors (PDE5i; such as Sildenafil; Vardenafil; Tadalafil) treatment as well as urology referral to the old patient vignette. The young patient vignette was more often referred to a sexologist and received a more positive prognosis than the older patient.
Conclusions: This study demonstrates an age bias among physicians regarding sexuality in later life. Of particular note is the increased prescription of PDE5i to the older patient, despite the clear psychosocial indication presented in the case vignette.