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Insomnia management in Dutch general practice: a routine care database study
Mette H Bakker1,2, Nina A Oldejans1, Jacqueline G Hugtenburg2,3
1Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Scandinavian Journal of Primary Health Care
|July 20, 2023
Summary
Dutch general practitioners frequently prescribe sleep medication, often unrecommended or repeated benzodiazepine receptor agonist (BZRA) prescriptions, despite guidelines favoring non-pharmacological insomnia management. This study highlights common medication practices in primary care.
Area of Science:
- General Practice
- Sleep Medicine
- Pharmacology
Background:
- Insomnia management guidelines in general practice emphasize non-pharmacological interventions.
- Concerns exist regarding the prevalent prescription of sleep medication, including unrecommended and long-term use.
Purpose of the Study:
- To investigate insomnia management strategies in Dutch general practice.
- To focus on the patterns of sleep medication prescription in primary care settings.
Main Methods:
- A descriptive analysis of anonymized electronic medical records (EMRs) from 21 general practices in the Netherlands.
- Data included patient demographics, consultation notes, and sleep medication prescriptions for patients with a 'Sleep disturbance' (ICPC code P06) diagnosis.
Main Results:
- Of 1,089 patients, 77.0% received sleep medication, with 64.6% prescribed at the first consultation.
- 76.8% received benzodiazepine receptor agonists (BZRAs), 39.5% received unrecommended drugs, and 14.7% received over 180 BZRA pills within two years.
- Non-pharmacological interventions were documented for 48.4% of patients.
Conclusions:
- Sleep medication prescription is common in Dutch general practice, often initiated at the first consultation.
- Prescriptions frequently involve unrecommended drugs and repeated BZRA use, contrary to clinical guidelines.
- There is a significant gap between recommended and actual insomnia treatment practices in primary care.
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