Diagnostic and treatment strategies for erectile dysfunction: the 'Processof Care' model

The new era of erectile dysfunction medicine ushered in by the availability of an effective and safe oral medication paves the evolution of the field toward a multi-disciplinary and primary care setting. There exists a paucit y of guidelines regarding the assessment and management of the patient with erectile dysfunction in the primary care arena. The 'Process of Care' mode l for the evaluation and treatment of erectile dysfunction has been develop ed to advance new guidelines for the diagnosis and management of erectile d ysfunction in the primary care and multi-disciplinary setting, This model w as developed under the auspices of the University of Medicine and Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School (chairman: R Rose n) with input from a multi-disciplinary group of experts including represen tation from primary care, internal medicine, endocrinology, psychiatry, psy chology and urology.dagger The methodology employed was a modified delphi-technique (RAND method). The key components of the model are: a rational approach to diagnosis and treatment emphasis on clinical history-taking and a focused physical examination specialized testing and referral in pre-defined situations step-wise management approach with ranking of treatment options and incorporation of patient and partner needs and preferences in the decision making process when possible (a goal-directed approach). The management algorithm is conceptually organized into progressive stages from Process-->Action-->Outcome.