Patients' and clinicians' experiences and perceptions of the primary care management of insomnia: qualitative study.

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dc.cclicenceCC-BY-NCen
dc.contributor.authorDavy, Zowieen
dc.contributor.authorMiddlemass, Jen
dc.contributor.authorSiriwardena, A. Nen
dc.date.acceptance2013-07-17en
dc.date.accessioned2016-10-25T08:33:06Z
dc.date.available2016-10-25T08:33:06Z
dc.date.issued2013-08-19
dc.descriptionOpen Access articleen
dc.description.abstractBackground: Insomnia is common leading to patients with sleep problems often presenting to primary care services including general practice, community pharmacies and community mental health teams. Little is known about how health professionals in primary care respond to patients with insomnia. Aim: We aimed to explore health professionals’ and patients’ experiences and perceptions of the management of insomnia in primary care. Design: We used a qualitative design and thematic approach. Setting: Primary care in Nottinghamshire and Lincolnshire. Method: We undertook focus groups and one-to-one interviews with a purposive sample of health professionals and adults with insomnia. Results: We interviewed 28 patients and 23 health professionals. Practitioners focused on treating the cause of insomnia rather than the insomnia itself. They described providing stepped care for insomnia, but this focused on sleep hygiene which patients often disregarded, rather than cognitive behavioural therapy for insomnia (CBT-I). Practitioners were ambivalent towards hypnotic drugs but often colluded with patients to prescribe to avoid confrontation or express empathy. Patients sometimes took hypnotics in ways that were not intended, for example together with over the counter medication. Practitioners and patients were sometimes but not always concerned about addiction. Practitioners sometimes prescribed despite these concerns but at other times withdrew hypnotics abruptly without treating insomnia. Both patients and practitioners wanted more options and better training for the management of insomnia in primary care. Conclusion: A better understanding of the current approaches and difficulties in the management of insomnia will help to inform more therapeutic options and health professional training.en
dc.funderEPSRC (Engineering and Physical Sciences Research Council)en
dc.identifier.citationDavy, Z., Middlemass, J., and Siriwardena, A. N. (2015) Patients' and clinicians' experiences and perceptions of the primary care management of insomnia: qualitative study. Health Expectations, 18 (5), pp. 1371–1383en
dc.identifier.doihttps://doi.org/10.1111/hex.12119
dc.identifier.urihttp://hdl.handle.net/2086/12729
dc.language.isoenen
dc.peerreviewedYesen
dc.projectidEP/I000615/ 1en
dc.publisherWileyen
dc.researchinstituteInstitute of Health, Health Policy and Social Careen
dc.subjectcognitive behavioural therapy for insomniaen
dc.subjectinsomniaen
dc.subjectprescribing practicesen
dc.subjecttreatmenten
dc.titlePatients' and clinicians' experiences and perceptions of the primary care management of insomnia: qualitative study.en
dc.typeArticleen

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