title: [Effectiveness of short educational intervention in patients with insomnia in primary care].
abstract: OBJECTIVE
  To evaluate the effectiveness of providing an educational intervention in primary care (PC) alongside a pharmacological treatment for insomnia.
  
  
  METHODS
  Single blinded non randomised clinical trial.
  
  
  METHODS
  Two urban primary health centers in Gijón (Asturias, Spain).
  
  
  METHODS
  Patients who consulted for insomnia between July 2012-January 2013 and met the inclusion criteria (n=50) were assigned systematically to the control group (CG) or intervention group (IG). All patients initiated treatment with lorazepam 1mg in the evenings and had four weekly 15 min visits plus a follow-up visit after another month.
  
  
  METHODS
  The IG received training for control of stimuli, sleep hygiene and respiration and relaxation techniques in the four visits. The CG had only non invasive measures taken.
  
  
  METHODS
  Considering as cured those who reached a Pittsburgh Sleep Quality Index PSQI <6 or a 50% reduction from baseline level. It was also analyzed the change in the PSQI from baseline to final visit and to follow-up visit, and voluntary interruption of lorazepam. Analysis by Bayesian inference.
  
  
  RESULTS
  Twelve out of recoveries after intervention against one out of 24 among control group. Mean change in PSQI to final visit and follow-up visit was: -4.7 (95%CrI:-5.9 to -3.5) and -6,3 (95%ICred: -7.5 to -5.1) in IG; -1.8 (95%ICred: -3 to -0.5) and -1.7 (95%ICred: -2.9 to -0.4) in CG. Interruption of lorazepan: in 4 controls (16,7%) and 9 (34,6%) in IG. Twenty nine patients in GI and 17 in GC completed the trial. Per protocol analysis showed similar results.
  
  
  CONCLUSIONS
  The educational intervention in PC improves sleep quality and reduces the need of treatment with benzodiacepines.
authors.affiliation: Centro de Salud El Llano, Área V, Gijón, Asturias, España. Electronic address: anagancedogarcia@gmail.com.
authors.forename: Ana
authors.initials: A
authors.lastname: Gancedo-García
authors.affiliation: Centro de Salud El Llano, Área V, Gijón, Asturias, España.
authors.forename: Angélica Faviola
authors.initials: AF
authors.lastname: Gutiérrez-Antezana
authors.affiliation: Centro de Salud Contrueces, Área V, Gijón, Asturias, España.
authors.forename: Pablo
authors.initials: P
authors.lastname: González-García
authors.affiliation: Centro de Salud Contrueces, Área V, Gijón, Asturias, España.
authors.forename: Sally
authors.initials: S
authors.lastname: Salinas-Herrero
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Londres, Reino Unido.
authors.forename: David
authors.initials: D
authors.lastname: Prieto-Merino
authors.affiliation: Unidad de Investigación Área V, Hospital de Cabueñes, Gijón, Asturias, España.
authors.forename: Patricio
authors.initials: P
authors.lastname: Suárez-Gil
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D011320:Primary Health Care; D016037:Single-Blind Method; D007319:Sleep Initiation and Maintenance Disorders / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Atención primaria; Bayesian methods; Benzodiacepinas; Benzodiazepines; Clinical trial; Educación en salud; Education for health; Ensayo clínico; Insomnia; Insomnio; Primary care; Teorema de Bayes