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No. 106. ACCEPT ( A sian C onstraints and C oncerns in the E D P erception and T reatment): Result of the comparison of PDE5-I and TCM as the treatment option for ED in Asian population. KW. TIANG 1 , NY.NEO 2 , KL. LIM 3 , AHA. RAZACK 3 , EG. LEE 4

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No. 106

ACCEPT (Asian Constraints and Concerns in the ED Perception and Treatment): Result of the comparison of PDE5-I and TCM as the treatment option for ED in Asian population


1University of Queensland, St. Lucia, Australia; 2University of Edinburgh, Edinburgh, United Kingdom; 3University of Malaya, Kuala Lumpur, Malaysia; 4Monash University, Selangor DarulEhsan, Malaysia


The treatment of erectile dysfunction (ED) with Phosphodiesterase5- Inhibitor (PDE5-I) is relatively new compared to Traditional Complementary Medicine (TCM) in Asia.

TCM has been an integral part of therapy in Asian culture 1and the acceptance of pharmaceutical intervention for ED is relatively not as well established.


A total of 3372 subjects (2032 males and 1340 females) were recruited. Forty four percent of subjects had a secondary level education compared to 32% of subjects that had a university education. Almost 61% of subjects had a low to medium income.

Overall, 89% of the subjects perceived ED as treatable with PDE5-I with 82% efficacy, compared to TCM with 62% treatability and 73% effectiveness.

PDE5-I is considered safe in 73% against 57% for TCM, while 33% and 30% believed the options are linked to sudden death, respectively. Forty five percent considered PDE5-I to be addictive versus 38% on TCM.

PDE5-I is considered trustworthy in 75% of all with 74% willing to accept it as first line treatment, compared to 54% trusting TCM with 49% acceptability. There was no difference of opinions between gender (P= 0.115) and sexual activeness (P= 0.256) in the group who trust TCM as the treatment option for ED.


ACCEPT study was conducted in Malaysia to compare the perception and attitude towards two therapeutic options for ED.


Patients who attended non-urological clinics in a tertiary teaching hospital were recruited to complete non-validated questionnaires.

The questionnaire aimed to identify participants’ views on PDE5-I and TCM in the areas of efficacy, safety, trustworthiness and acceptability. Sub-analysis of the subjects’ race, gender, age, income, educational background and sexual activeness were also analyzed.

ACCEPT study was conducted in Malaysia as the overall population (28.3 million) is representative of culturally diverse Asia (Malays 67.4%, Chinese 24.6%, Indian 7.3%, Others 0.7%).2

Fig.1 Percentage of patients who believe that ED is treatable

Fig 2. Percentage of patients that believe treatment for ED is effective


PDE5-I as oral treatment of ED has been available for more than a decade in most Asian Countries, which is a relatively short interval compared to the existence of TCM.

ACCEPT study outlined a favorable perception of PDE5-I as an effective, safe and trustworthy treatment option of ED, with high acceptability. Contrary to perceptions the risk of sudden death with PDE5-I is unfounded. 3

Despite such positive attitude towards PDE5-I, TCM still have strong foothold and acceptability amongst Asians even though there is insufficient evidence available in the literature with regard to its efficacy and safety. 1Targeted patient awareness is important to clearly differentiate and improve the acceptance of PDE5-I as the primary treatment modality for ED.

Fig 4. Percentage of patients that believe treatment for ED is related to sudden death

Fig 3. Percentage of patients that believe treatment for ED is safe


Ho CC, Tan HM Rise of Herbal and Traditional Medicine in Erectile Dysfunction Management CurrUrol Rep 2011;12:470-478

Population & Housing Census of Malaysia 2010. Department of Statistics Malaysia. Available at: Accessed 23 February 2012

Eardley I. Oral Therapy for Erectile Dysfunction. Arch EspUrol 2010;63(8):703-714


This study was made possible through an unrestricted educational grant from Pfizer Malaysia

Poster presentation sponsor