Compliance of sildenafil treatment for erectile dysfunction and factors affecting it

To assess the compliance of treatment, its affecting factors, and reasons for dropout, a questionnaire was mailed to a cohort of 2139 subjects who received sildenafil prescriptions for erectile dysfunction (ED) at our institution from 1999 to 2002. A total of 726 subjects (34%) with a mean age of 67 years answered the questionnaires. The response rate for sildenafil treatment was 67%. Of these sildenafil responders, 43% reported that they continued using sildenafil while 57% did not, in a mean follow-up of 3 years. Common reasons for discontinuation were effect below expectations, high cost, loss of interest in sex, and inconvenience in obtaining sildenafil. The continuers showed a higher rate than the discontinuers (P < 0.05) of having tried other treatments, dose titration, and a dose higher than 50 mg. The discontinuers reported having a lower mean responding dose and improvement score post sildenafil treatment than the continuers. In conclusion, effect below expectations was the leading reason for discontinuation of sildenafil treatment. How ED subjects tried the medication and the adequacy of education in the initial treatment period may impact the compliance of sildenafil treatment.