Primary health care practitioner perspectives on the management of insomnia: a pilot study
Janet M. Y. Cheung A , Kristina Atternäs B , Madeleine Melchior B , Nathaniel S. Marshall C D , Romano A. Fois A and Bandana Saini A E
+ Author Affiliations
- Author Affiliations
A Faculty of Pharmacy, S303, Pharmacy Building A15, The University of Sydney, Sydney, NSW 2006, Australia.
B Department of Pharmaceutical Biosciences, Division of Pharmacokinetics and Drug Therapy, Faculty of Pharmacy, Uppsala University, 751 23, Uppsala, Sweden.
C NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS) and the Sydney Nursing School, The University of Sydney, Sydney, NSW 2006, Australia.
D Sydney Nursing School, The University of Sydney, Sydney, NSW 2006, Australia.
E Corresponding author. Email: bandana.saini@sydney.edu.au
Australian Journal of Primary Health 20(1) 103-112 https://doi.org/10.1071/PY12021
Submitted: 21 February 2012 Accepted: 3 December 2012 Published: 28 February 2013
Abstract
This paper reports a qualitative pilot study exploring primary care health practitioners’ perspectives on the management of insomnia following the extensive media coverage on the adverse effects of zolpidem in 2007–08. General practitioners and community pharmacists were recruited throughout metropolitan Sydney, New South Wales using a convenience sampling and snowballing technique. Demographic information was collected from each participant followed by a semistructured interview. In total 22 participants were interviewed, including eight general practitioners and 14 community pharmacists. Interview transcripts were analysed using ‘framework analysis’. Participants’ responses illuminated some of the key issues facing primary care practitioners in the management of insomnia. Practitioners perceived there to be an overreliance on pharmacotherapy among insomnia patients and inadequate support for directing patients to alternative treatment pathways if they require or prefer non-pharmacological management. Current prescribing trends appear to favour older benzodiazepines in new cases of insomnia whereas some successful sporadic users of zolpidem have continued to use zolpidem after the media coverage in 2007–08. The findings of this pilot study suggest the need to address the limitations in the management of insomnia within the current health care system, to revise and disseminate updated insomnia guidelines and to provide educational opportunities and resources to primary care practitioners concerning management options.
Additional keywords: framework analysis, general practitioner, insomnia management, pharmacist, primary care, provider perspectives, qualitative research, zolpidem.
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