The prevalence and popularity of direct-to-consumer (DTC) telehealth platforms has risen sharply in recent years, which now offer a broad range of specialty services, including psychiatric, dermatologic, bariatric, and gynecologic care. For men seeking care for erectile dysfunction (ED), a growing number of sites, including Hims® and Roman® provide fully virtual diagnosis and treatment, often without the requirement for live consultation with a medical provider. Many DTC platforms also advertise their role as a source of patient information on the pathogenesis of ED and mechanisms for treatment. In this study, we formally assess the quality of this online health information among the largest DTC telepharmacies.
Using site traffic data from Semrush®, a digital marketing tool, we identified the five largest telepharmacies offering both ED treatment and information for patients. We then employed a series of validated metrics for online health information (JAMA score, LIDA instrument, DISCERN, Flesch Ease of Reading) to assess the information quality on each site using three independent reviewers.
We found wide variation in the accuracy and reliability of health information between sites, with content on the two largest (Hims®, Roman®) generally scoring higher on quality metrics than the three smallest (BlueChew®, Numan®, Lemonaid®). Points were most frequently deducted for failure to properly source medical claims, incomplete discussion of alternate treatments, and inadequate disclosure of funding source. Written content from all platforms was deemed “difficult” or “fairly difficult” on the Flesch Ease of Reading test.
Recent studies have identified a worrying increase in the prevalence of ED in men under 40, a demographic that is among the most reluctant to seek traditional medical care for sexual health concerns. Within this context, DTC telehealth platforms have emerged as a compelling alternative for men seeking fully virtual consultation and treatment of ED. Our results underscore the concern that DTC users are at risk of receiving incomplete or inaccurate counseling, particularly in the absence of guidance from an unaffiliated medical provider. Alongside other potential drawbacks, including the lack of physical exam, potentially inadequate follow-up care, and financial waste, our work highlights the need for additional study and oversight into the safety and efficacy of DTC telehealth for ED treatment.
Written by: Dylan J. Mittauer, BS1 Hasan F. Jhaveri, MD2 Thomas E. Schroeder, MD2 Andrew C. Peterson, MD, MPH2
- Division of Urologic Surgery, WashU Medicine
- Department of Urology, Duke University Medical Center