Viagra Connect: How to Obtain the Medication

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. 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.

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

aRMMs were considered effective if ≥ 80 % of pharmacists provided correct answers to questions pertaining to KRMs. 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.

• 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.

From 4000 invited pharmacies, 387 were screened (response rate: 9.7 %), and 357 were eligible (eligibility: 92.2 %).

• The packaging includes clear dosing instructions.
• Pharmacists can advise on proper usage and precautions.
• Do not share medication with others.
• Discontinue use if side effects worsen.
• Report any adverse reactions to a healthcare provider.
• Keep track of your dosage schedule for safety.

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 %). 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.

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

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 strongest viagra pill questions concerning concomitant medications not recommended with Viagra Connect® (Table 3).

• 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.

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 answers were “false”, Table 4).

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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 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 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.

Study design

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. 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). 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).

• Important to check for allergies to sildenafil before use.
• Side effects like dizziness should be taken seriously.
• Consult a doctor if you experience vision changes.
• Viagra Connect does not protect against STDs.
• It’s recommended to avoid caffeine before taking.
• Medication should be used responsibly and as directed.

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. 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).

Product	Dosage	Quantity + Bonus	Price
Viagra Generic	25mg	180 + 6 Pills	154.93€ 147.55€	Buy
Viagra Professional	100mg	90 + 2 Pills	207.09€ 197.23€	Buy
Viagra Generic	50mg	60 + 4 Pills	83.93€ 79.93€	Buy
Viagra Professional	100mg	180 + 4 Pills	337.30€ 321.24€	Buy
Viagra Super Active	100mg	270 + 30 Pills	390.61€ 372.01€	Buy
Viagra Generic	100mg	270 + 10 Pills	270.47€ 257.59€	Buy
Viagra Generic	150mg	30 + 2 Pills	72.32€ 68.88€	Buy
Viagra Generic	50mg	90 + 6 Pills	107.37€ 102.26€	Buy
Viagra Original	100mg	14 + 2 Pills	89.03€ 84.79€	Buy
Viagra Soft Tabs	100mg	60 + 6 Pills	152.94€ 145.66€	Buy
Viagra Original	100mg	12 Pills	72.54€ 69.09€	Buy
Viagra Soft Tabs	100mg	20 Pills	62.99€ 59.99€	Buy
Viagra Generic	200mg	120 + 8 Pills	204.80€ 195.05€	Buy
Viagra Professional	100mg	120 + 4 Pills	262.83€ 250.31€	Buy
Viagra Generic	25mg	10 Pills	25.19€ 23.99€	Buy
Viagra Professional	100mg	20 Pills	71.14€ 67.75€	Buy
Viagra Generic	50mg	360 + 10 Pills	225.33€ 214.60€	Buy

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 priligy and viagra %) were comfortable counselling patients.

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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 priligy and viagra %) were comfortable counselling patients.

Key risk messages

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. 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®. Most (72.2 %) agreed patients were interested in learning and open to discussing their health.

Associated Data

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. 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.

Ethics approval

aRMMs were considered effective if ≥ 80 % of pharmacists provided correct answers to questions pertaining to KRMs. 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. 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. 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.

What do Sildenafil 50mg Tablets contain?

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®.

Participation inViagra Connect®training guide to pharmacists

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®. 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]. 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.

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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.

Viagra: Different Dosages

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 viagra packaging 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]. 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].

Materials and Methods

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].

How long do the effects last?

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 viagra packaging 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®. 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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Respondents tended to be male (69.9 %), 41–60 years of age (40.3 %), and had been dispensing medications for ≥ 11 years (63.2 %). 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.

Awareness and utilisation ofViagra Connect®Pharmacy Checklist

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 strongest viagra pill 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). 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.

Owner

Fabienne Heyne
[email protected]

Design & Implementation

Jonas Bünter
www.jonas.work

Photography

Angelika Annen
www.angelikaannen.ch