Differences Between Prescription and Pharmacy Supply

Five of 28 items assessed knowledge of KRMs in Part 1. At least 80 % of pharmacists selected correct responses to 24/28 items (Table 3). The majority correctly responded to questions concerning concomitant diseases which may be contributing to ED. The lowest correct response rate was observed for “Men who had a heart attack or stroke > 6-months ago should not be supplied Viagra Connect® but should be referred to their doctor”, with 41.4 % correctly answering “False”. At least 80 % of respondents correctly answered questions concerning concomitant medications not recommended with Viagra Connect® (Table 3). Questions regarding suitability of patients to use Viagra Connect® when on a different dose of sildenafil or other ED treatment(s), when taking riociguat for lung problems, or beta-blockers (correct answers: “false”, “no”, “yes”, respectively) did not reach ≥ 80 % correct response rate. CI confidence interval, ED erectile dysfunction, PPI proton pump inhibitor a95 % exact two-sided CIs are calculated using the Clopper–Pearson method Four questions consisting of 23 items were used to assess knowledge of KRMs in Part 2. At least 80 % of respondents correctly answered 19/23 items (Table 4).

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Overall, a good level of uptake, engagement, and awareness of the Viagra Connect® aRMMs programme was seen within the UK pharmacy setting. These results may be important for informing policy regulators in other countries considering reclassification of Viagra® to non-prescription status. With the availability of understandable information and online resources, society is better educated than ever about health and therapy options [11]. This has led to pharmacists experiencing increased responsibilities in facilitating self-care, with patients requesting medications for acute or long-term conditions [12]. While this study surveyed the main sources of pharmacists’ knowledge for dispensing Viagra Connect®, we acknowledge that pharmacists may have obtained information from other sources (Online Resource 4), and it is challenging to isolate the impact of a specific communication medium via a knowledge survey.

Participation inViagra Connect®training guide to pharmacists

Of the 31 % of respondents in this study who did not participate or recall participating in the Viagra Connect® training, most cited a lack of awareness (32.7 %) or prior PGD-training for PDE5Is (19.6 %). It has been suggested that pharmacists lack confidence when supplying medications reclassified from POM to P-medicine [13], and see themselves as educators rather than decision-makers, deferring decision-making to other medical professionals in ambiguous cases [14]. Our survey suggests that when community pharmacists were unsure (i.e., < 80 % correctly answered 8/51 items), a risk-averse approach was adopted, and pharmacists directed patients to their doctor instead of supplying Viagra Connect®. These observations are consistent with the suggestion that pharmacists see safety as the over-riding concern with supply of over-the-counter or BTC medications [15]. Indeed, a study suggested that visits to physicians/nurse practitioners significantly increased amongst users following reclassification of Viagra Connect® [16]. At least 80 % correctly identified that patients should be advised to stop taking Viagra Connect® and seek immediate medical help if they experience chest pains, persistent/painful erections (> 4 h), loss of vision, or an allergic reaction. Below 80 % correctly identified that patients who experience headache or nausea do not need to stop taking Viagra Connect® and seek medical attention (correct viagra medicine answers were “false”, Table 4).

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At least 80 % correctly identified conditions that may cause ED, and that patients with evidence of undiagnosed depression, anxiety, or excessive alcohol use should receive lifestyle advice and follow-up with their doctor.

• Viagra Connect is an over-the-counter treatment for erectile dysfunction.
• It contains sildenafil, which improves blood flow to the penis.
• Available in pharmacies without a prescription.
• Patients should consult a pharmacist before use.
• Suitable for men aged 18 and over.
• Must be taken at least 30 minutes before activity.

Below 80 % correctly identified hypertension and hypercholesterolemia as possible causes of ED (Table 4). Most respondents understood that all patients supplied Viagra Connect® should be offered lifestyle advice, and advised to consult their doctor within 6 months of first supply, and that patients whose request for Viagra Connect® was refused should be advised to contact their doctor. a95 % exact two-sided CIs are calculated using the Clopper–Pearson method Nearly all respondents were aware of the optional Viagra Connect® Pharmacy Checklist, and the majority used this at point-of-supply (91.9 %; Table 5).

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At least 80 % of respondents confirmed the Essential Information for the Supply of Viagra Connect® training guide, Viagra Connect® Pharmacy Checklist, and tear-off slip were extremely useful/very useful (90.1 %, 96.8 %, 82.9 %, respectively). Of 345 respondents, 161 (46.7 %) reported the training guide being their main reference source, and one-third referred primarily to the checklist for safe dispensing practices of Viagra Connect® (Online Resource 4). Of 345 respondents, the majority (91.3 %) were comfortable counselling patients. Most (72.2 %) agreed patients were interested in learning and open to discussing their health. However, 53.0 % reported that discussing Viagra Connect® made some patients uncomfortable and unwilling to divulge information (Fig.

Assessment by Pharmacist for Patient Suitability for VC

Only 5.2 % of respondents felt uncomfortable counselling about Viagra Connect®. In recent years, there has been a move towards supporting self-care, and a key element of this has been the switching from POM to P-medicine, available BTC at pharmacies. We found that community pharmacists had a good level of knowledge and awareness of KRMs for Viagra Connect®, and, when unsure, acted in cenforce viagra a risk-averse manner and did not supply Viagra Connect®. Awareness of the KRMs suggests the training materials were effective for educating community pharmacists on key aspects of its supply. To our knowledge, this was the first assessment of the effectiveness of aRMMs for a BTC-available product. Of the 28 (8.1 %) who did not/did not recall using the checklist, only 6 were unaware it existed.

• Viagra Connect may interact with certain medications.
• Be aware of potential contraindications.
• Not for use with certain blood pressure medicines.
• Consult a healthcare professional before starting.
• Do not use if you have recent heart surgery.
• Regular check-ups can ensure safe use of ED medication.

Nearly all respondents who utilised the checklist used it all the time (97.2 %). The majority (91.3 %) always provided the tear-off slip when supplying Viagra Connect® (Table 5). PDE-5i phosphodiesterase type-5 inhibitor, PGD patient-group direction aPercentages calculated based on the sample presented with this question because of skip logic bPercentages may not total 100 % as > 1 response could be selected Of eligible respondents, 69.0 % (n=238) participated in the Viagra Connect® training, with the most popular format being printed materials received in the mail, followed by online training supplied by their pharmacy (Online Resource 3). Of 107 respondents who did not participate, 47 could not recall if they had taken part. The most common reason given for not participating was lack of awareness (32.7 %), and 21 pharmacists (19.6 %) were already PGD-trained for PDE5Is. At least 80 % of respondents confirmed the Essential Information for the Supply of Viagra Connect® training guide, Viagra Connect® Pharmacy Checklist, and tear-off slip were extremely useful/very useful (90.1 %, 96.8 %, 82.9 %, respectively). Of 345 respondents, 161 (46.7 %) reported the training guide being their main reference source, and one-third referred primarily to the checklist for safe dispensing practices of Viagra Connect® (Online Resource 4). Of 345 respondents, the majority (91.3 %) were comfortable counselling patients.

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Five of 28 items assessed knowledge of KRMs in Part 1. At least 80 % of pharmacists selected correct responses to 24/28 items (Table 3). The majority correctly responded to questions concerning concomitant diseases which may be contributing to ED. The lowest correct response rate was observed for “Men who had a heart attack or stroke > 6-months ago should not be supplied Viagra Connect® but should be referred to their doctor”, with 41.4 % correctly answering “False”. At least 80 % of respondents correctly answered questions concerning concomitant medications not recommended with Viagra Connect® (Table 3).

Data Source and Measurement

Questions regarding suitability of patients to use Viagra Connect® when on a different dose of sildenafil or other ED treatment(s), when taking riociguat for lung problems, or beta-blockers (correct answers: “false”, “no”, “yes”, respectively) did not reach ≥ 80 % correct response rate. CI confidence interval, ED erectile dysfunction, PPI proton pump inhibitor a95 % exact two-sided CIs are calculated using the Clopper–Pearson method Four questions consisting of 23 items were used to assess knowledge of KRMs in Part 2. At least 80 % of respondents correctly answered 19/23 items (Table 4). At least 80 % correctly identified that patients should be advised to stop taking Viagra Connect® and seek immediate medical help if they experience chest pains, persistent/painful erections (> 4 h), loss of vision, or an allergic reaction. Below 80 % correctly identified that patients who experience headache or nausea do not need to stop taking Viagra Connect® and seek medical attention (correct viagra medicine answers were “false”, Table 4). Most (72.2 %) agreed patients were interested in learning and open to discussing their health.

• Viagra Connect offers a discreet way to manage ED.
• It works best when taken on an empty stomach.
• Full effect may take up to an hour to manifest.
• Avoid heavy meals immediately before taking.
• Regular use does not lead to dependency.
• An active lifestyle may improve results.

However, 53.0 % reported that discussing Viagra Connect® made some patients uncomfortable and unwilling to divulge information (Fig. Only 5.2 % of respondents felt uncomfortable counselling about Viagra Connect®. In recent years, there has been a move towards supporting self-care, and a key element of this has been the switching from POM to P-medicine, available BTC at pharmacies.

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Viagra Connect Sildenafil 50mg Tablets 8s

We found that community pharmacists had a good level of knowledge and awareness of KRMs for Viagra Connect®, and, when unsure, acted in cenforce viagra a risk-averse manner and did not supply Viagra Connect®. Awareness of the KRMs suggests the training materials were effective for educating community pharmacists on key aspects of its supply. To our knowledge, this was the first assessment of the effectiveness of aRMMs for a BTC-available product. Overall, a good level of uptake, engagement, and awareness of the Viagra Connect® aRMMs programme was seen within the UK pharmacy setting. These results may be important for informing policy regulators in other countries considering reclassification of Viagra® to non-prescription status. With the availability of understandable information and online resources, society is better educated than ever about health and therapy options [11]. This has led to pharmacists experiencing increased responsibilities in facilitating self-care, with patients requesting medications for acute or long-term conditions [12]. While this study surveyed the main sources of pharmacists’ knowledge for dispensing Viagra Connect®, we acknowledge that pharmacists may have obtained information from other sources (Online Resource 4), and it is challenging to isolate the impact of a specific communication medium via a knowledge survey. Of the 31 % of respondents in this study who did not participate or recall participating in the Viagra Connect® training, most cited a lack of awareness (32.7 %) or prior PGD-training for PDE5Is (19.6 %). It has been suggested that pharmacists lack confidence when supplying medications reclassified from POM to P-medicine [13], and see themselves as educators rather than decision-makers, deferring decision-making to other medical professionals in ambiguous cases [14].

Requirement	Details	Importance
Age Verification	Must be over 18 years old	Legal requirement
Medical History	No contraindications for erectile dysfunction drugs	Safety reasons
Prescription Status	Not required if purchased as OTC in some regions	But sometimes verified online
Contact Information	Valid phone number and email address	For order confirmation and support

Our survey suggests that when community pharmacists were unsure (i.e., < 80 % correctly answered 8/51 items), a risk-averse approach was adopted, and pharmacists directed patients to their doctor instead of supplying Viagra Connect®. These observations are consistent with the suggestion that pharmacists see safety as the over-riding concern with supply of over-the-counter or BTC medications [15]. Indeed, a study suggested that visits to physicians/nurse practitioners significantly increased amongst users following reclassification of Viagra Connect® [16]. Our survey also demonstrated that the Viagra Connect® Pharmacy Checklist was widely utilised (91.9 %), and nearly all pharmacists (96.8 %) found it useful/very useful. Although doctors and pharmacists play a critical role in encouraging self-care, they are reliant on information from consumer health sources [17]. Utilisation of the checklist at point-of-supply may help reduce ambiguity, provide support for gaps in knowledge, and embolden community pharmacists in their decision to supply Viagra Connect®.

Key features of Sildenafil 50mg Tablets

Our study should be considered in light of additional considerations. The overall response rate was 9.7 %, of whom 8.6 % completed the voluntary survey, despite email reminders and financial remuneration. However, the proportion of respondents was double that anticipated (~5 %). Low response rates are common among surveys of healthcare professionals [20–28], reported < 3 % in some publications [24, 25]. The present survey took ~19.6 min to complete, and although longer surveys (> 10 min) are associated with a lower response rate [29–31], our completion rate was high (96.6 %).

Patients’ Reported Experience with Visiting or Planning to Visit Their Doctor

We sought to recruit 200 pharmacists, but achieved 387 responses, allowing broader understanding of the implementation of the Viagra Connect® training materials and checklist. To avoid limiting to pharmacists with experience supplying Viagra Connect®, those with > 1 patient request for Viagra Connect® could participate. Despite our best efforts to ensure pharmacies surveyed were representative of the UK pharmacy population [32, 33], only 30 % of responding pharmacists were female, although women form the majority of practising pharmacists (62.0 %) [21]. This may be a consequence of the male-specificity of Viagra Connect®, although this was not specifically questioned. We cannot exclude the possibility that respondent characteristics, knowledge of the safety profile of sildenafil citrate, motivations, and general awareness of aRMMs differ between pharmacists who chose not to respond to the invitation. As a result of this survey, training materials were updated to improve knowledge of underlying health conditions as possible contributors to ED, and medications contraindicated with Viagra Connect®. These educational materials are still available cheap viagra with dapoxetine to pharmacists [7].

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At least 80 % correctly identified conditions that may cause ED, and that patients with evidence of undiagnosed depression, anxiety, or excessive alcohol use should receive lifestyle advice and follow-up with their doctor. Below 80 % correctly identified hypertension and hypercholesterolemia as possible causes of ED (Table 4). Most respondents understood that all patients supplied Viagra Connect® should be offered lifestyle advice, and advised to consult their doctor within 6 months of first supply, and that patients whose request for Viagra Connect® was refused should be advised to contact their doctor. a95 % exact two-sided CIs are calculated using the Clopper–Pearson method Nearly all respondents were aware of the optional Viagra Connect® Pharmacy Checklist, and the majority used this at point-of-supply (91.9 %; Table 5). Of the 28 (8.1 %) who did not/did not recall using the checklist, only 6 were unaware it existed.

Patients’ Experience Regarding the Advice from the Pharmacist to Consult Their Doctor Within 6 Months of First Supply of VC

Nearly all respondents who utilised the checklist used it all the time (97.2 %). The majority (91.3 %) always provided the tear-off slip when supplying Viagra Connect® (Table 5). PDE-5i phosphodiesterase type-5 inhibitor, PGD patient-group direction aPercentages calculated based on the sample presented with this question because of skip logic bPercentages may not total 100 % as > 1 response could be selected Of eligible respondents, 69.0 % (n=238) participated in the Viagra Connect® training, with the most popular format being printed materials received in the mail, followed by online training supplied by their pharmacy (Online Resource 3). Of 107 respondents who did not participate, 47 could not recall if they had taken part. The most common reason given for not participating was lack of awareness (32.7 %), and 21 pharmacists (19.6 %) were already PGD-trained for PDE5Is. Patient counselling is integral to a community pharmacist’s decision to dispense Viagra Connect®. We found pharmacists were comfortable counselling patients, and the majority perceived patients open to discussing their health, whereas previous studies suggested men were embarrassed to talk about their health and hesitant to seek treatment [18]. Amongst men diagnosed with ED, few pursue treatment [19]. In our study, 90 % of respondents reported patient satisfaction with counselling, suggesting patients were receptive to advice on ED and its treatment from pharmacists. With patients receptive to information from providers other than their primary care physician, and the good level of knowledge demonstrated by community pharmacists in counselling patients, there is real opportunity for patients to receive education and long-term management for ED independently of their doctor.

Choosing the Right Viagra Connect Pack

Our survey also demonstrated that the Viagra Connect® Pharmacy Checklist was widely utilised (91.9 %), and nearly all pharmacists (96.8 %) found it useful/very useful. Although doctors and pharmacists play a critical role in encouraging self-care, they are reliant on information from consumer health sources [17]. Utilisation of the checklist at point-of-supply may help reduce ambiguity, provide support for gaps in knowledge, and embolden community pharmacists in their decision to supply Viagra Connect®. As a result of this survey, training materials were updated to improve knowledge of underlying health conditions as possible contributors to ED, and medications contraindicated with Viagra Connect®. These educational materials are still available cheap viagra with dapoxetine to pharmacists [7].

Patients’ Experience with Visiting or Planning to Visit Their Doctor

Patient counselling is integral to a community pharmacist’s decision to dispense Viagra Connect®. We found pharmacists were comfortable counselling patients, and the majority perceived patients open to discussing their health, whereas previous studies suggested men were embarrassed to talk about their health and hesitant to seek treatment [18]. Amongst men diagnosed with ED, few pursue treatment [19]. In our study, 90 % of respondents reported patient satisfaction with counselling, suggesting patients were receptive to advice on ED and its treatment from pharmacists. With patients receptive to information from providers other than their primary care physician, and the good level of knowledge demonstrated by community pharmacists in counselling patients, there is real opportunity for patients to receive education and long-term management for ED independently of their doctor. Our study should be considered in light of additional considerations. The overall response rate was 9.7 %, of whom 8.6 % completed the voluntary survey, despite email reminders and financial remuneration. However, the proportion of respondents was double that anticipated (~5 %). Low response rates are common among surveys of healthcare professionals [20–28], reported < 3 % in some publications [24, 25]. The present survey took ~19.6 min to complete, and although longer surveys (> 10 min) are associated with a lower response rate [29–31], our completion rate was high (96.6 %). We sought to recruit 200 pharmacists, but achieved 387 responses, allowing broader understanding of the implementation of the Viagra Connect® training materials and checklist. To avoid limiting to pharmacists with experience supplying Viagra Connect®, those with > 1 patient request for Viagra Connect® could participate. Despite our best efforts to ensure pharmacies surveyed were representative of the UK pharmacy population [32, 33], only 30 % of responding pharmacists were female, although women form the majority of practising pharmacists (62.0 %) [21]. This may be a consequence of the male-specificity of Viagra Connect®, although this was not specifically questioned. We cannot exclude the possibility that respondent characteristics, knowledge of the safety profile of sildenafil citrate, motivations, and general awareness of aRMMs differ between pharmacists who chose not to respond to the invitation.

Data Type	Description	Usage
Personal Details	Name, DOB, Address	Confirm identity
Medical History	Past health conditions, current medications	Assess suitability
Payment Details	Credit/debit card information	Process payment
Contact Info	Phone number, email address	Order updates, notifications