Short-term training increases diagnostic and treatment rate for insomnia in general practice.
OBJECTIVE
To evaluate the effect of short-term training of general practitioners (GPs) on their diagnosis and treatment of chronic insomnia.


METHODS
A three-step randomized control group design was used: After baseline evaluation (T1) a group of 9 GPs underwent a training of half a day, while 7 GPs served as a control group. The diagnostic and therapeutic handling of insomnia patients was reevaluated under obligatory use of a structured diagnostic questionnaire (T2) and under optional use of it (T3).


RESULTS
From 16 general practices, 4,754 patients were included. The frequency rate of insomnia was 19.3 %. The lowest diagnostic and treatment rate was found for insomnia patients without comorbidity (15 % at T1). Systematic non-pharmacological treatment was not offered by the GPs. At T2 the diagnosis rate increased significantly from 37.9 % (T1) to 71.5 % (T2, p = 0.038). It fell back to lower levels at T3 but remained better than at T1. At T3 non-pharmacological treatments and referral to a sleep expert were advised more often.


CONCLUSIONS
Short-term training of GPs can significantly improve their diagnostic sensitivity and first-line treatment efforts against insomnia.
Backhaus
Jutta
J
University Hospital, Department of Psychiatry and Psychotherapy, Ratzeburger Allee 160, 23538 Luebeck, Germany. Backhaus.J@psychiatry.mu-luebeck.de
Junghanns
Klaus
K
Mueller-Popkes
Kristin
K
Broocks
Andreas
A
Riemann
Dieter
D
Hajak
Goeran
G
Hohagen
Fritz
F
D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003479:Curriculum; D004502:Education, Medical, Continuing / Q000379:methods; D005858:Germany; D006801:Humans; D008875:Middle Aged; D010821:Physicians, Family / Q000193:education* / Q000706:statistics & numerical data; D015397:Program Evaluation / Q000379:methods; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000628:therapy; D011795:Surveys and Questionnaires; D013997:Time Factors