The development of a sleep disorder screening program in Australian community pharmacies.
OBJECTIVE
To develop, pilot and determine the feasibility of a sleep-specific screening and awareness program in community pharmacies.


METHODS
The screening was piloted in five Australian community pharmacies.


METHODS
The Pharmacy Tool for Assessment of Sleep Health was constructed by drawing on known relationships between sleep disorders, and lifestyle factors, medical conditions and medications. Four validated instruments were used in the screening tool: the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Multivariable Apnea Prediction Index (MAPI) and International Restless Legs Syndrome Study Group Screening Criteria (IRLS). These instruments were used to predict the participant's risk of a sleep disorder and the results were compared with reported lifestyle, medical and medication factors. On-site training of consenting pharmacists was provided, followed by an eight week client recruiting and screening period. Feedback was elicited from participating pharmacists and clients.


METHODS
The feasibility of, and trends found from, the developed screening tool and protocol.


RESULTS
Of 167 clients who requested or were invited to participate by pharmacists, 84 (50.3%) were screened. Analysis of collected data indicated that 33.3%, 21.4% and 27.4% of participants were at risk of having or developing insomnia, obstructive sleep apnea (OSA) and restless legs syndrome (RLS) respectively, while 38.1% were not at risk of any of the screened disorders. OSA odds increased 12.8 times (95% CI: 3.2-50.4) with diabetes and 4.9 times (1.2-20.9) with opioid use, while shift workers were 8.4 times (1.6-43.2) more likely to have insomnia. Participants and pharmacists reported the screening protocol and instrument was user friendly and feasible.


CONCLUSIONS
The development and pilot of this screening tool was successful. The prevalence of sleep disorders in the sampled population was high but generally consistent with previous studies on the general population. Furthermore, associations found may form a foundation for a clinical algorithm to identify those at a higher risk of having or developing a sleep disorder. Further work is required to validate this screening tool in the community pharmacy context.
Tran
Adam
A
Faculty of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia.
Fuller
Joanne M
JM
Faculty of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia.
Wong
Keith K
KK
Sleep & Circadian Research Group, Woolcock Institute of Medical Research, Camperdown, Sydney, NSW, 2050, Australia.|Department of Respiratory & Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, 2050, Australia.
Krass
Ines
I
Faculty of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia.
Grunstein
Ron
R
Sleep & Circadian Research Group, Woolcock Institute of Medical Research, Camperdown, Sydney, NSW, 2050, Australia.|Department of Respiratory & Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, 2050, Australia.|Faculty of Medicine, University of Sydney, Sydney, Australia.
Saini
Bandana
B
Faculty of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia. bandana@pharm.usyd.edu.au.
D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D003625:Data Collection / Q000379:methods / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards; D010594:Pharmacies / Q000592:standards; D010595:Pharmacists / Q000592:standards; D010865:Pilot Projects; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000453:epidemiology*