Evaluating the Quality of Asynchronous Versus Synchronous Virtual Care in Patients With Erectile Dysfunction: Retrospective Cohort Study

BACKGROUND: Asynchronous health care encounters are becoming an increasingly mainstream form of telehealth. While synchronous phone or video visits have become more widely accepted, US policymakers and other key health care stakeholders have been hesitant to fully embrace asynchronous diagnosis and treatment. This is particularly true in the context of direct-to-consumer (DTC) platforms, where encounters are patient-initiated and there is no preestablished relationship with a provider. This hesitation is compounded by limited research comparing outcomes between asynchronous and synchronous care, especially in the DTC context. OBJECTIVE: The purpose of this study was to explore whether asynchronous care leads to different patient outcomes in the form of medication-related adverse events when compared to synchronous virtual care. METHODS: Using 10,000 randomly sampled patient records from a prominent US-based DTC platform, we analyzed the rates of patient-reported side effects from commonly prescribed erectile dysfunction medications and compared these rates across modalities of treatment. RESULTS: Asynchronous care resulted in lower but nonsignificant differences in the rates of the reported drug-related side effects compared to synchronous treatment. CONCLUSIONS: In some circumstances, such as treatment for erectile dysfunction, asynchronous care can offer the same level of safety in prescribing when compared to synchronous care. More research is needed to evaluate the safety of asynchronous care across a wider set of conditions and measures.