Viagra Connect Sildenafil 50mg Tablets 8s

To our knowledge, this was the first assessment of the effectiveness of aRMMs for a BTC-available product.

Associated Data

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. Most (72.2 %) agreed patients were interested in learning and open to discussing their health. Overall, a good level of uptake, engagement, and awareness of the Viagra Connect® aRMMs programme was seen within the UK pharmacy setting.

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These results may be important for informing policy regulators in other countries considering reclassification of Viagra® to non-prescription status.

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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. We found that community pharmacists had a good level of knowledge and awareness of KRMs for Viagra Connect®, and, when unsure, acted in 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. With the availability of understandable information and online resources, society is better educated than ever about health and therapy options [11].

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A sample of 200 completed surveys was planned, based on statistical and practical considerations. A completed survey was defined when all questions relevant to participant’s responses (following skip logic) were answered. Only data from completed surveys were included. Frequency distributions with 95 % CIs were calculated using the Clopper–Pearson method. aRMMs were considered effective if ≥ 80 % of pharmacists provided correct answers to questions pertaining to KRMs.

Assessment for Suitability for VC by Pharmacist

This level was agreed upon as a reasonable threshold, as there are no established criteria or published literature to provide valid thresholds for measuring effectiveness of aRMMs. From 4000 invited pharmacies, 387 were screened (response rate: 9.7 %), and 357 were eligible (eligibility: 92.2 %). In total, 345 eligible respondents completed the survey (completion rate: 96.6 %) (Online Resource 2). Mean completion time was ~19.6 min. Respondents tended to be male (69.9 %), 41–60 years of age (40.3 %), and had been dispensing medications for ≥ 11 years (63.2 %). This has led to pharmacists experiencing increased responsibilities in facilitating self-care, with patients requesting medications for acute or long-term conditions [12].

Tip	Description	Benefit
Use a stable internet connection	To prevent data loss during submission	Faster processing
Prepare necessary documents	ID and medical history if required	Smooth verification process
Double-check entries	Ensure accuracy before submitting	Reduces need for follow-up
Read instructions carefully	To avoid missing important information	Completes the process efficiently

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.

Platform	Type	Availability	Contact Support	Notes
Official Pharmacy Website	E-commerce website	24/7	Online chat, email	Verified sources
Mobile App	App-based ordering	Business hours	In-app support	Convenience for repeat customers
Telehealth Consultation	Doctor-assisted purchase	Limited regions	Phone or video chat	Requires medical consultation
Third-party Pharmacy Websites	Online retailers	Varies	Support varies	Verify authenticity before purchase

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 %).

Step Number	Action	Required Information	Duration	Notes
1	Visit the Website	None	2 minutes	Access via desktop or mobile browser
2	Fill Personal Details	Name, Date of Birth, Address	3 minutes	Ensure accurate data entry
3	Medical Questionnaire	Medical history questions	4 minutes	Privacy is maintained
4	Confirm Identity	Photo ID upload (if needed)	5 minutes	May vary based on verification needs

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].

• Viagra Connect requires a brief health assessment at purchase.
• Patients should disclose any health issues or medications.
• Alcohol consumption may reduce effectiveness.
• It does not cause an instant erection; arousal needed.
• Side effects are usually mild and temporary.
• Seek medical advice if experiencing persistent problems.

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].

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Most pharmacists were located in an urban setting (73.9 %), and nearly half worked for a large pharmacy chain. 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”.

Statistical Analyses

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). 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. 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.

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Online only pharmacists who did not conduct face-to-face consultations were excluded. Data protection requirements were complied with before contacting pharmacists. A random sample of pharmacists across 4000 pharmacies were sent postal invitations including a weblink to the survey. The purpose of the survey, how data would be reported, and confidentiality were explained in the invitation. Email reminders were sent after 1 week and 1 month of initial invitation.

Patients’ Experience of Being Advised About the Appropriate/Safe Use of VC, the Potential Cause of ED, and Offered Lifestyle Advice

Each pharmacy received a single-use code to exclude duplicate entries by multiple respondents. If > 1 pharmacist per pharmacy wanted to participate, an additional code was requested. Respondents were offered a single financial remuneration for a completed survey, based on fair-market-value of expected completion time. Data were collected via a structured, self-administered online questionnaire. The questionnaire comprised 33 closed-ended questions with multiple-choice responses that covered the study objectives and screening, demographics, experience with Viagra Connect®, utilisation of the checklist and tear-off slip, attitudes towards patient counselling and towards Viagra Connect® training. Although doctors and pharmacists play a critical role in encouraging self-care, they are reliant on information from consumer health sources [17].

• 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.

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 to pharmacists [7]. Patient counselling is integral to a community pharmacist’s decision to dispense Viagra Connect®.

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Below 80 % correctly identified that patients who experience headache or nausea do not need to stop taking Viagra Connect® and seek medical attention (correct answers were “false”, Table 4). 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 viagra pfizer 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).

Pharmacists’ Advice to Patients About the Appropriate/Safe Use of VC

Of the 28 (8.1 %) who did not/did not recall using the checklist, only 6 were unaware it existed. 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.