Why do sleep disorders remain undermanaged? Insights from pharmacists and physicians using the COM-B framework

There is limited understanding of how community pharmacists and physicians support sleep health management in Arabic-speaking countries.

This study aims to utilize the Capability, Opportunity, Motivation-Behavior (COM-B) model to explore the perspectives and practices of pharmacists and physicians in addressing sleep health issues and identify the drivers and barriers influencing these practices.

Semi-structured individual interviews were conducted with a purposive sample of pharmacists and physicians in the United Arab Emirates. Interview guides were developed based on the COM-B framework. All interviews were audio-recorded and transcribed verbatim. Data were coded using NVivo software Version 14 (formerly QSR International) and analyzed deductively based on the theoretical framework.

A total of 45 health care providers (29 pharmacists and 16 physicians) were interviewed. Participants perceived sleep-related concerns in the general population to be insufficiently addressed. Shared barriers to addressing sleep concerns included limited time, lack of knowledge, and formal training, and stigma surrounding sleep. Pharmacists referred chronic cases to physicians and dispensed sedating antihistamines or herbal products to acute cases and were hindered by the lack of private counseling areas and limited therapeutic options. Physicians were reluctant to prescribe medications due to possible dependency and insurance concerns. Both provider groups recognized the importance of sleep to overall health and expressed motivation to help their patients.

This study provides shared and profession-specific barriers and enablers that shape sleep health care provision practices of pharmacists and physicians in the region. It provides avenues for targeted interventions to improve sleep health care delivery in primary care and community settings.