Treating insomnia in Swiss primary care practices: A survey study based on case vignettes.

Linder, Stefanie; Duss, Simone B.; Dvořák, Charles; Merlo, Christoph; Essig, Stefan; Tal, Kali; Del Giovane, Cinzia; Syrogiannouli, Lamprini; Heinzer, Raphael; Nissen, Christoph; Bassetti, Claudio L.A.; Auer, Reto; Maire, Micheline (2021). Treating insomnia in Swiss primary care practices: A survey study based on case vignettes. Journal of sleep research, 30(1), e13169. Wiley-Blackwell 10.1111/jsr.13169

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Guidelines recommend cognitive behavioural therapy for insomnia (CBT-I) as first-line treatment for chronic insomnia, but it is not clear how many primary care physicians (PCPs) in Switzerland prescribe this treatment. We created a survey that asked PCPs how they would treat chronic insomnia and how much they knew about CBT-I. The survey included two case vignettes that described patients with chronic insomnia, one with and one without comorbid depression. PCPs also answered general questions about treating chronic insomnia and about CBT-I and CBT-I providers. Of the 820 Swiss PCPs we invited, 395 (48%) completed the survey (mean age 54 years; 70% male); 87% of PCPs prescribed sleep hygiene and 65% phytopharmaceuticals for the patient who had only chronic insomnia; 95% prescribed antidepressants for the patient who had comorbid depression. In each case, 20% of PCPs prescribed benzodiazepines or benzodiazepine receptor agonists, 8% prescribed CBT-I, 68% said they knew little about CBT-I, and 78% did not know a CBT-I provider. In the clinical case vignettes, most PCPs treated chronic insomnia with phytopharmaceuticals and sleep hygiene despite their lack of efficacy, but PCPs rarely prescribed CBT-I, felt they knew little about it, and usually knew no CBT-I providers. PCPs need more information about the benefits of CBT-I and local CBT-I providers and dedicated initiatives to implement CBT-I in order to reduce the number of patients who are prescribed ineffective or potentially harmful medications.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Linder, Stefanie; Duss, Simone; Tal, Kali; Del Giovane, Cinzia; Syrogiannouli, Lamprini; Nissen, Christoph; Bassetti, Claudio; Auer, Reto and Maire, Micheline Célia Dina

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0962-1105

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

15 Oct 2020 21:18

Last Modified:

19 Feb 2021 14:19

Publisher DOI:

10.1111/jsr.13169

PubMed ID:

32951295

Uncontrolled Keywords:

chronic insomnia cognitive behavioural therapy for chronic insomnia primary care treatment

BORIS DOI:

10.7892/boris.146864

URI:

https://boris.unibe.ch/id/eprint/146864

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