Clinical inertia in sexual medicine practice

Table 1 Overview of clinical inertia in sexual medicine practice

CI at the population level
Primordial prevention
CI to follow a healthy lifestyle (e.g., eating habits and physical activity to reduce the development of risk factors). Inertia in preventing sexual abuse in society
CI at the patient level
Primary prevention
CI in identifying and intervening susceptible individuals (e.g., identifying people with diabetes with risk of ED at the earlier stage and intervening)
Secondary prevention
CI in identifying and intervening those with subclinical disease (e.g., identifying people with diabetes with early ED at the earlier stage and intervening)
CI in identifying and intervening those with the clinical disease (e.g., identifying people with diabetes with established ED and intervening)
Tertiary prevention
CI in appropriately treating those with clinical disease (e.g., identifying people with diabetes with established ED and intervening)
Quaternary prevention
CI in appropriately down-titrating the dose of medication in those with the clinical disease who do not require (overmedication) (e.g., identifying people with established ED on multiple medications for ED, which are ineffective in that particular patient and intervening by stopping ineffective medications)
Quinary prevention
CI in identifying and intervening misinformation/misconception regarding the clinical disease. CI in identifying and correcting misconceptions such as “there is no treatment for sexual problems” and “ED is a part of aging”

CI: Clinical inertia; ED: Erectile dysfunction.