title: Primary health care practitioner perspectives on the management of insomnia: a pilot study.
abstract: 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.
authors.affiliation: Faculty of Pharmacy, S303, Pharmacy Building A15, The University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Janet M Y
authors.initials: JM
authors.lastname: Cheung
authors.affiliation: Department of Pharmaceutical Biosciences, Division of Pharmacokinetics and Drug Therapy, Faculty of Pharmacy, Uppsala University, 751 23, Uppsala, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Atternäs
authors.affiliation: Department of Pharmaceutical Biosciences, Division of Pharmacokinetics and Drug Therapy, Faculty of Pharmacy, Uppsala University, 751 23, Uppsala, Sweden.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Melchior
authors.affiliation: NHMRC Centre for Integrative Research and Understanding of Sleep (CIRUS) and the Sydney Nursing School, The University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Nathaniel S
authors.initials: NS
authors.lastname: Marshall
authors.affiliation: Faculty of Pharmacy, S303, Pharmacy Building A15, The University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Romano A
authors.initials: RA
authors.lastname: Fois
authors.affiliation: Faculty of Pharmacy, S303, Pharmacy Building A15, The University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Bandana
authors.initials: B
authors.lastname: Saini
mesh_terms: D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data; D019538:Health Care Surveys / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007407:Interviews as Topic; D008297:Male; D009517:New South Wales; D010865:Pilot Projects; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000379:methods*; D011725:Pyridines / Q000627:therapeutic use; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000628:therapy*; D014505:Urban Population; D000077334:Zolpidem
chemical_list: D006993:Hypnotics and Sedatives; D011725:Pyridines; D000077334:Zolpidem