Patients' and clinicians' experiences of consultations in primary care for sleep problems and insomnia: a focus group study

Dyas, Jane; Apekey, Tanefa; Tilling, Michelle; Ørner, Roderick; Middleton, Hugh; Siriwardena, Aloysius Niroshan

doi:10.3399/bjgp10x484183

Cited by 76 publications

(106 citation statements)

References 34 publications

Supporting

Mentioning

101

Contrasting

Unclassified

Order By: Relevance

“…The nine included studies were published between 2003 and 2015 and were from four countries (Australia, Belgium, UK, USA) [12,13,9,[14][15][16][17][18][19]. Participants in these studies were mainly older adults that were frequent users of BZDs.…”

Section: Data Extractionmentioning

confidence: 99%

“…For three studies [12,16,17] the primary focus was on insomnia, whilst for others the primary focus was on broader aspects of the use of these drugs and (in some cases) implications for service development.…”

Section: Data Extractionmentioning

confidence: 99%

“…anxiety), we were unable to create equivalent themes for these conditions from the data available. Three studies [12,17,16] gave insight into patients' perceptions of insomnia, its causes and consequences, and the relationship between this condition and medical help-seeking.…”

Section: Patients' Negative Perceptions Of Insomnia and Its Impactmentioning

confidence: 99%

“…"'I said to my doctor recently, "when I die…I don't want breast cancer on my death certificate, I don't want emphysema, I want insomnia because I am sure that's at the root of all my problems'" [17] "'I think a lot of it is because I'm so tired, that is what causes the depression'" [17] Secondly, insomnia was cited as being caused by other health problems. For example, arthritic pain and heart failure were cited as causing/precipitating insomnia; and patients viewed insomnia as being perpetuated by other comorbid physical and mental health conditions such as back pain, nocturia and anxiety.…”

Section: Patients' Negative Perceptions Of Insomnia and Its Impactmentioning

confidence: 99%

“…"'I was having marriage problems because of this thing of not sleeping'" [17] "Insomnia often led to inability to do or enjoy previously enjoyable activities, such as concerts, travelling, shopping or visiting with grandchildren" [12] "They were plagued with memory problems, stating that their 'minds were not what they used to be' and perceived that their memory problems are worse after 'a bad night'" [12] The perceived severity of this negative impact of insomnia was one factor which led patients to seek medical help.…”

Section: Patients' Negative Perceptions Of Insomnia and Its Impactmentioning

confidence: 99%

See 4 more Smart Citations

A Systematic Review and Meta-Synthesis of Patients’ Experiences and Perceptions of Seeking and Using Benzodiazepines and Z-Drugs: Towards Safer Prescribing

Sirdifield

Chipchase

Owen

et al. 2016

Patient

View full text Add to dashboard Cite

Acknowledgements: Thank you to Rebecca Porter (School of Health and SocialCare, University of Lincoln) for her support with data extraction for this project.Sirdifield led the study and contributed to all stages of the analysis and write-up Chipchase contributed to all stages of the analysis and write up Owen read and commented on drafts of the paper and model, and proof read the final version Siriwardena had the idea for this study, and has contributed to the design, conception, analysis and drafts of the paper (including final revisions). AbstractBackground: Benzodiazepines and z-drugs are used to treat complaints like insomnia, anxiety and pain. These drugs are recommended for short-term use only, but many studies report long-term use, particularly in older people.Objective: To identify and synthesise qualitative studies exploring patients' experiences and perceptions of receiving benzodiazepines and z-drugs, and through this identify factors which perpetuate use of these drugs, and strategies for achieving safer prescribing.Methods: A systematic search of six databases for qualitative studies exploring patients' experiences and perceptions of primary care benzodiazepine and z-drug prescribing published between January 2000 and April 2014 in a European language, and conducted in Europe, the United States, Australia or New Zealand. Reference lists of included papers were also searched. Study quality was assessed using the Critical Appraisal Skills Programme qualitative checklist. Findings were synthesised using thematic synthesis.Results: Nine papers were included and seven analytical themes were identified relating to patients' experiences and perceptions and, within that, strategies for safer prescribing of benzodiazepines and z-drugs: 1) patients' negative perceptions of insomnia and its impact, 2) failed self-care strategies, 3) triggers to medical helpseeking, 4) attitudes towards treatment options and service provision, 5) varying patterns of use, 6) withdrawal, 7) reasons for initial or ongoing use. Conclusions:Inappropriate use and prescribing of benzodiazepines and z-drugs is perpetuated by psychological dependence, absence of support and patients' denial/lack of knowledge of side-effects. Education strategies, increased availability of alternatives, and targeted extended dialogue with patients could support safer prescribing. Key Points Long-term use of benzodiazepines and z-drugs can have adverse consequences, but research reports long-term use, particularly in older people 4  We identified seven themes from published qualitative research which add to our understanding of patients' experiences and perceptions of seeking and using these drugs, and factors perpetuating their use  Safer prescribing could be supported through education strategies for patients and healthcare professionals, increased availability of alternatives, and targeted extended dialogue between patients and healthcare professionals 5

show abstract