JMIR Publications

ABSTRACT

Background:

Topic modeling of patient medication reviews (PMRs) of erectile dysfunction (ED) drugs can help identify the patient preferences regarding ED treatment options.

Objective:

This study aimed to test 1) whether the topics identified for each ED drug reflect drug labeling information, marketing claims, and other patient concerns; 2) whether the distribution of primary topics varies with patient characteristics (patient age and time on ED drug therapy); and 3) whether the satisfaction with ED drug therapy depends on the primary topics controlling for the patient characteristics.

Methods:

Data were collected from the PMRs of sildenafil and tadalafil posted on WebMD and Ask a Patient from March 4, 2001 to June 25, 2019. The latent Dirichlet allocation (LDA) method of natural language processing (NLP) was used to identify five distinctive topics from the PMRs on each drug. Analysis of variance (ANOVA) and two sample t-test were conducted to compare the topic distribution and test whether patient satisfaction varies with the primary topics, age, and time on medication for each ED drugs. Statistical significance was tested at an alpha of .05.

Results:

The PMRs of sildenafil (N = 463) had two topics on treatment benefit and one each on medication safety, marketing claim, and treatment comparison, while the PMRs on tadalafil (N = 919) had two on medication safety and one each on the remaining subjects. Sildenafil’s reviewers quite frequently (94/463, 20.4%) mentioned erection sustainability as their primary topic, whereas tadalafil’s reviewers were more concerned about severe medication safety. Those who mentioned erection sustainability as their primary topic were quite satisfied with their treatment as opposed to those for whom the primary topic was severe medication safety (3.85 vs. 2.44). The discovered topics reflected the marketing claims of “Blue Magic” and “Amber Romance” respective of each drug. The topic of Blue magic t was preferred among younger patients while the topic of amber romance topic was preferred among older patients. The topic “Alternative Choices” which appeared for both the ED pills reflected the patient interest in the comparative effectiveness and prices outside the drug labeling information.

Conclusions:

PMRs of ED drugs reflect patient preferences regarding drug labeling information, marketing claims, and alternative treatment choices. The patient preferences concerning ED treatment attributes inform the design of patient-centered communication for improved ED drug therapy.