Erectile dysfunction (ED) is a prevalent condition with significant psychosocial and cardiometabolic implications, particularly in ageing populations. This quality improvement project evaluated whether the assessment and management of ED at a community general practice aligned with contemporary clinical guidelines, including those from the British Society for Sexual Medicine and the European Association of Urology. A retrospective audit was conducted using electronic patient records from a cohort of individuals prescribed ED medications between July 2023 and July 2024. Fifty patients were randomly selected, excluding those diagnosed prior to 2017, to ensure relevance to current standards. Three key criteria were assessed: appropriate biochemical investigation for underlying causes, documentation of cardiovascular (CVD) risk assessment, and prescribing of cost-effective first-line pharmacotherapy. Audit performance demonstrated that 41/50 patients (82%) received recommended blood tests (standard: 85%), 38/50 patients (76%) underwent documented CVD risk assessment (standard: 80%), and 45/50 patients (90%) were prescribed low-cost phosphodiesterase type 5 inhibitors (standard: 90%). While prescribing practices met expected standards, gaps were identified in comprehensive investigation and cardiovascular evaluation. Findings suggest that although ED management at the practice is broadly aligned with national guidance, improvements are needed in systematic risk assessment and documentation. The observed pattern between incomplete investigations and lack of CVD assessment highlights the need for structured consultation templates and increased clinician awareness. Recommendations include the implementation of validated assessment tools, enhanced coding practices, and patient education on the relationship between ED and cardiovascular health. A re-audit is advised to assess the impact of these interventions. This project underscores the importance of holistic ED management in primary care, with implications for both patient outcomes and healthcare sustainability.
Cureus. 2026 May 05*** epublish ***
Adithya Ajith
Internal Medicine, The University of Sheffield, Sheffield, GBR.