'Is it the crime of the century?': factors for psychiatrists and service users that influence the long-term prescription of hypnosedatives.
Given the longstanding controversy about hypnosedative use, we aimed to investigate the attitudes of prescribing psychiatrists and service users towards long-term use of hypnosedative medication, and their perceptions of barriers to evidence-based nonmedication alternatives. Qualitative data from focus groups in Aotearoa/NZ were analysed thematically. A novel research design involved a service user researcher contributing throughout the research design and process. Service users and psychiatrists met to discuss each other's views, initially separately, and subsequently together. Analysis of the data identified four key themes: the challenge, for both parties, of sleep disturbance among service users with mental health problems; the conceptual and ethical conflicts for service users and psychiatrists in managing this challenge; the significant barriers to service users accessing evidence-based nonmedication alternatives; and the initial sense of disempowerment, shared by both service users and psychiatrists, which was transformed during the research process. Our results raise questions about the relevance of the existing guidelines for this group of service users, highlight the resource and time pressures that discourage participants from embarking on withdrawal regimes and education programmes on alternatives, highlight the lack of knowledge about alternatives and reflect the complex interaction between sleep and mental health problems, which poses a significant dilemma for service users and psychiatrists.
Department of Psychological Medicine, University of Otago Wellington, Wellington, New Zealand.
Joanna
J
MacDonald
Christopher
C
Garvie
Sarah
S
Gordon
Mark
M
Huthwaite
Fiona
F
Mathieson
Amber-Jane
AJ
Wood
Sarah
S
Romans
D022126:Access to Information; D001291:Attitude of Health Personnel; D000529:Complementary Therapies; D003220:Conflict, Psychological; D054626:Consumer Health Information; D004334:Drug Administration Schedule; D011307:Drug Prescriptions; D017723:Drug Utilization Review; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008603:Mental Health; D009520:New Zealand; D010353:Patient Education as Topic; D010465:Perception; D010818:Practice Patterns, Physicians'; D036301:Qualitative Research; D018570:Risk Assessment; D012307:Risk Factors; D012890:Sleep / Q000187:drug effects*; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome
D006993:Hypnotics and Sedatives