Treating insomnia in Swiss primary care practices: A survey study based on case vignettes.

Details

Serval ID
serval:BIB_FCD38A5E35F8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Treating insomnia in Swiss primary care practices: A survey study based on case vignettes.
Journal
Journal of sleep research
Author(s)
Linder S., Duss S.B., Dvořák C., Merlo C., Essig S., Tal K., Del Giovane C., Syrogiannouli L., Heinzer R., Nissen C., Bassetti CLA, Auer R., Maire M.
ISSN
1365-2869 (Electronic)
ISSN-L
0962-1105
Publication state
Published
Issued date
02/2021
Peer-reviewed
Oui
Volume
30
Number
1
Pages
e13169
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Guidelines recommend cognitive behavioural therapy for insomnia (CBT-I) as first-line treatment for chronic insomnia, but it is not clear how many primary care physicians (PCPs) in Switzerland prescribe this treatment. We created a survey that asked PCPs how they would treat chronic insomnia and how much they knew about CBT-I. The survey included two case vignettes that described patients with chronic insomnia, one with and one without comorbid depression. PCPs also answered general questions about treating chronic insomnia and about CBT-I and CBT-I providers. Of the 820 Swiss PCPs we invited, 395 (48%) completed the survey (mean age 54 years; 70% male); 87% of PCPs prescribed sleep hygiene and 65% phytopharmaceuticals for the patient who had only chronic insomnia; 95% prescribed antidepressants for the patient who had comorbid depression. In each case, 20% of PCPs prescribed benzodiazepines or benzodiazepine receptor agonists, 8% prescribed CBT-I, 68% said they knew little about CBT-I, and 78% did not know a CBT-I provider. In the clinical case vignettes, most PCPs treated chronic insomnia with phytopharmaceuticals and sleep hygiene despite their lack of efficacy, but PCPs rarely prescribed CBT-I, felt they knew little about it, and usually knew no CBT-I providers. PCPs need more information about the benefits of CBT-I and local CBT-I providers and dedicated initiatives to implement CBT-I in order to reduce the number of patients who are prescribed ineffective or potentially harmful medications.
Keywords
chronic insomnia, cognitive behavioural therapy for chronic insomnia, primary care, treatment
Pubmed
Web of science
Create date
13/10/2020 11:29
Last modification date
17/02/2021 7:27
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