Primary health care practitioner perspectives on the management of insomnia: a pilot study

被引:40
作者
Cheung, Janet M. Y. [1 ]
Atternas, Kristina [2 ]
Melchior, Madeleine [2 ]
Marshall, Nathaniel S. [3 ,4 ]
Fois, Romano A. [1 ]
Saini, Bandana [1 ]
机构
[1] Univ Sydney, Fac Pharm, Sydney, NSW 2006, Australia
[2] Uppsala Univ, Dept Pharmaceut Biosci, Div Pharmacokinet & Drug Therapy, Fac Pharm, S-75123 Uppsala, Sweden
[3] Univ Sydney, NHMRC Ctr Integrated Res & Understanding Sleep CI, Sydney, NSW 2006, Australia
[4] Univ Sydney, Sydney Nursing Sch, Sydney, NSW 2006, Australia
关键词
framework analysis; general practitioner; insomnia management; pharmacist; primary care; provider perspectives; qualitative research; zolpidem; TREATMENT SEEKING; GENERAL-PRACTICE; HELP-SEEKING; BENZODIAZEPINE; ATTITUDES; IMPLEMENTATION; EPIDEMIOLOGY; PREDICTORS; BARRIERS; THERAPY;
D O I
10.1071/PY12021
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
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.
引用
收藏
页码:103 / 112
页数:10
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