PharmaZzz: Feasibility and Impact of Pharmacist-Delivered Cognitive Behavioural Therapy for Chronic Insomnia
Author(s): ,
Karen Jensen
Affiliations:
BSP MSc
,
Loren Regier
Affiliations:
BSP
,
Janelle Trifa
Affiliations:
BSP
Lindsay Edgington
Affiliations:
BSP candidate 2017
Canadian Pharmacists Conference ePoster Library. Remillard F. Jun 3, 2017; 174257
Dr. Fred Remillard
Dr. Fred Remillard
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Abstract
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Objectives
CBTi is first line treatment for insomnia but is widely underutilized due to lack of education, awareness and especially trained providers. Recent research reports CBTi can be effectively provided by non-sleep experts. The objectives of this study were to investigate the feasibility of pharmacists delivering CBTi and the impact of this service on patients sleep patterns and use of hypnotics.

Methods
This observational cohort study was conducted in two phases. In Phase 1, a training manual for pharmacists and accompanying patient workbook were developed by our student researcher. These were reviewed and revised by a focus group of selected community pharmacists. In Phase 2, interested community and primary healthcare pharmacists were recruited to attend a one day workshop to train for CBTi, then asked to recruit and provide CBTi to five patients with chronic insomnia during the next year (August 1st, 2015 to July 31, 2016). Pharmacists recorded de-identified patient participant data on the PharmaZzz webpage.

Results
he workshop was attended by 13 community and 3 primary healthcare pharmacists; of these 6 (38%) were able to recruit patients during the 1 year study period. A total of 27 patients were recruited (34% of the number expected) and 11 (41%) attended all 6 CBTi sessions. After completing the program, 8 patients (73%) demonstrated improved sleep behaviours and 9 (82%) reported an average sleep efficiency of 89%. Of the 7 patients taking hypnotics, 3 (43%) were able to decrease hypnotic use and 2 (29%) were able to stop hypnotic use completely.

Conclusion
Pharmacists are able to effectively deliver CBTi in both community and primary healthcare settings but time constraints, lack of reimbursement and difficulty recruiting and retaining patients are barriers to providing the service.

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