一个修改后的德尔菲共识,以重构和优先考虑英国初级保健中慢性失眠的管理
Alanna Hare1, Jasvinder Singh Kaler2, Lavan Baskaran3
1Guy's and St Thomas' NHS Foundation Trust, London, UK A.Hare@rbht.nhs.uk.
BMJ open
|November 7, 2025
概括
慢性失眠影响了英国数百万人,但管理不善. 这项研究制定了关于更好的初级保健诊断和治疗的共识建议,旨在改善患者的治疗结果.
科学领域:
- 睡眠医学 睡眠医学
- 公共卫生 公共卫生
- 医疗保健管理的管理
背景情况:
- 慢性失眠是英国普遍存在的睡眠障碍,影响6.8%-14.9%的成年人.
- 它带来了重大的健康和经济负担,但在初级保健机构中经常被诊断不足和管理不当.
- 现有的理解,诊断和管理方面的差距阻碍了有效的患者护理.
研究的目的:
- 解决英国关于慢性失眠的关键知识差距.
- 在国家卫生服务 (NHS) 内制定基于共识的建议,以优化慢性失眠护理途径.
- 改善初级保健中慢性失眠的诊断和管理.
主要方法:
- 一个经过修改的Delphi共识研究,涉及英国初级保健专业人员 (全科医生,药剂师,睡眠专家).
- 一个多学科的指导小组制定了39个陈述,通过对201名医疗保健专业人员 (HCP) 进行两轮Delphi调查来改进.
- 共识被定义为在4点利克特级别上≥75%的共识.
主要成果:
- 在39个陈述中,37个陈述达成了共识.
- 关键的发现包括承认慢性失眠是一种独特的慢性疾病.
- 建议强调例行睡眠查,加强医疗保健人员在失眠认知行为疗法 (CBT-I) 和药物治疗方面的培训,并提高公众的意识.
结论:
- 系统性障碍阻碍了有效的失眠护理,需要在英国初级保健中优先考虑慢性失眠.
- 协商一致的建议旨在减轻未经治疗的失眠的负担.
- 该研究旨在通过优化护理途径改善患者的治疗结果,医疗保健服务和经济生产力.
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