Journal of Sleep Disorders: Treatment and CareISSN: 2325-9639

Reach Us +18507546199
All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.

Pharmacotherapy for Chronic Insomnia: A Brief Survey of PCP Attitudes and Preferences

Purpose: To examine primary care professionals’ (PCP) attitudes and prescribing preferences toward hypnotic medications to treat chronic insomnia.
Methods: An online survey was sent to members of the Dartmouth CO-OP, a practice-based primary care research network in Maine, Vermont, and New Hampshire.  The survey begins with a case vignette of a 64-year old woman suffering from chronic insomnia.  Clinicians were then presented with eight questions about management of the patient and their attitudes toward prescribing medications, focusing on benzodiazepines/benzodiazepine receptor agonists (BDZ/BZRAs).
Results: 103 of 198 clinicians (52%) responded.  Regarding choice of medication for the case vignette, 81% of respondents preferred the off-label use of hypnotics such as trazodone or melatonin; 11% stated they would choose BDZs and 22% would choose BZRAs.  Strong majorities expressed that negative consequences would occur with use of BDZ/BZRAs, including tolerance (77%), dependence (68%), other side effects (53%), and addiction (51%). PCP preference for off- label prescribing was correlated to levels of concern about harms (addiction, dependence, tolerance, side effects) of BDZ/BZRAs as measured on a global medication risk score in this survey.  In addition, 14% of respondents felt that pharmacotherapy was not an appropriate therapeutic option for chronic insomnia in the case vignette.
Conclusion: Most of the clinicians surveyed acknowledged a legitimate role for hypnotic medications in chronic insomnia but expressed reservations toward BDZ/BZRAs despite their FDA-approval and proven efficacy.  There appears to be a gap between published guidelines for selection of sedative-hypnotic medications and PCP preferences. 

Special Features

Full Text

View

Track Your Manuscript

Share This Page

Media Partners

Associations