Premature ejaculation in primary care: communication strategies versus usual care for male patients consulting for a sexual, urogenital or psychological reason; the GET UP cluster randomized controlled trial

Marie Barais, Marine Costa, Camille Montalvo, Vincent Rannou, Hélène Vaillant Roussel, David Costa, Sébastien Cadier, Bruno Pereira

Keywords: premature ejaculation, general practice, sexual dysfunction

Premature ejaculation is the most common sexual dysfunction among men. A previous qualitative study identified six communication strategies described by general practitioners (GP) who had tackled the topic with their patients during consultations.

Research questions:
Is training in communication skills implementing these six strategies more effective than usual care on the incidence of patients bringing up the topic of premature ejaculation with their GP?

Cluster randomized controlled trial, stratified over four geographical areas areas comparing an intervention group that received a training session on the six strategies, and a control group that provided routine medical care. Participants were male patients between 18 and 80 years old and consulting for a sexual, urogenital or psychological reason were included. The intervention was a communication skill training session for GPs on the use of the six strategies identified in the previous qualitative study. The primary outcome was the efficacy of the training session in communication skills compared with usual care, evaluated as the percentage of patients who discussed the topic of premature ejaculation with their GP. The secondary objectives were: i) percentage of enrolled patients with premature ejaculation (identified by a score >9 of the Premature Ejaculation Diagnostic Tool filled in four weeks after the consultation); and ii) variation in quality of life (SF-12 scale score) of the enrolled patients between baseline and week 4 after the consultation for a sexual, urogenital or psychological reason.

130 patients were included by 32 GPs (n=16 in the intervention group and n=16 in the control group). The number of enrolled patients who discussed about premature ejaculation was higher in the intervention group than in the control group (42% vs. 4.9%, absolute difference = 37% 95%CI [24% to 50%], p <0.001).

Training GPs in communication strategies to talk about premature ejaculation improves its detection.

Points for discussion:
tackling premature ejaculation in general practice

experience with cluster randomized controlled trial