Integrated primary care insomnia management in Australia.

Abstract

There is growing support to expand the roles of pharmacists by recognizing their knowledge and skills beyond those around dispensing of medications. Introducing non-dispensing pharmacists at the premises of General Practitioners (GPs) for a collaborative service can potentially and significantly help to provide more effective and efficient health services, for example, in under-recognized or mismanaged conditions such as insomnia. Such a collaborative service could also reduce the costs and risks associated with long-term use of sedatives, besides improving patient's quality of life. This study aimed to elicit the perceptions of Australian GPs on the integration of pharmacists into general practice settings for providing sleep health services, especially insomnia services. Face to face interviews were conducted with a purposive convenience sample of GPs using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and the transcribed data were thematically analyzed using the principles of framework analysis to identify emergent themes. Twenty-four interviews (46% female participants) were conducted with GPs from greater Sydney Metropolitan area in New South Wales. Based on the Collaborative Working Relationship (CWR) framework, the current relationship between the participating GPs and pharmacists appeared to be at the early stage. Thematic analysis of the interviews indicated that despite citing some barriers such as funding models, infrastructure and perceived patient attitudes, most participants expressed a positive attitude towards this service model. The integrated insomnia service model was believed to be facilitating the provision of comprehensive care for patients with insomnia. The results of this study suggest that there is a willingness among GPs to utilize pharmacist support in insomnia management. Various facilitators, barriers, and methods of collaborative services were identified. A professional practice framework needs to be developed and established to implement the proposed model and ensure a better healthcare service for patients with insomnia.