Hypnotic prescription by GPs is associated with their personal drug consumption but not by their insomnia status.


Journal

Journal of sleep research
ISSN: 1365-2869
Titre abrégé: J Sleep Res
Pays: England
ID NLM: 9214441

Informations de publication

Date de publication:
08 2020
Historique:
received: 08 03 2019
revised: 27 09 2019
accepted: 20 01 2020
pubmed: 13 2 2020
medline: 20 3 2021
entrez: 13 2 2020
Statut: ppublish

Résumé

French general practitioners (GPs) are known to widely prescribe medications to treat insomnia despite their negative effects. GPs' easy access to self-medication may affect their mental representation of sleep and hypnotics, and subsequently their professional behaviour. Our aim was to examine the association between GPs' personal hypnotic drug consumption habits and their management of patients with sleep disturbances. A randomized sample of Alsatian GPs participated in a survey based on questionnaires including the Pittsburgh Sleep Quality Index, the Dysfunctional Beliefs About Sleep in 10 questions to characterize sleep, and an evaluation of their management strategies regarding sleep for both patients and themselves. Two-hundred and forty-nine GPs were included (response rate of 51%). Demographics of the GPs' samples were representative of those of the Alsatian GP population. Fifteen percent of the survey respondents met insomnia criteria. For the management of their own sleep disturbances, 14.3% of GPs were taking hypnotic drugs and 8.7% were taking anxiolytics, with greater drug consumption in the insomnia group. In a multivariate analysis, GPs who personally consumed these medications prescribed significantly more of them to patients, whereas their insomnia status had less impact. Other factors such as gender and type of practice were not associated with a higher prescription rate. Our results indicate that GPs' personal drug consumption can have a significant impact on the management of their patients, therefore suggesting that actions towards GPs' health improvement may also benefit their patients and the public.

Identifiants

pubmed: 32048384
doi: 10.1111/jsr.12993
doi:

Substances chimiques

Hypnotics and Sedatives 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e12993

Informations de copyright

© 2020 European Sleep Research Society.

Références

Allain, H., Bentué-Ferrer, D., Polard, E., Akwa, Y., & Patat, A. (2005). Postural instability and consequent falls and hip fractures associated with use of hypnotics in the elderly: A comparative review. Drugs & Aging, 22, 749-765.
American Academy of Sleep Medicine (2014). International classification of sleep disorders. Darien, IL: American Academy of Sleep Medicine.
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5(TM)). Washington DC: American Psychiatric Association.
ANSM (2017). État des lieux de la consommation des benzodiazépines en France. Retrieved from http://ansm.sante.fr/var/ansm_site/storage/original/application/28274caaaf04713f0c280862555db0c8.pdf.
Bjorvatn, B., Meland, E., Flo, E., & Mildestvedt, T. (2017). High prevalence of insomnia and hypnotic use in patients visiting their general practitioner. Family Practice, 34, 20-24.
Bourgeois-Jacquet, M. (2014). Le sommeil du médecin généraliste: Comment son propre vécu influence-t-il sa perception de l’insomnie et sa pratique? Étude qualitative auprès de 24 généralistes alsaciens non insomniaques. Medical thesis, Strasbourg, France.
Brandt, J., & Leong, C. (2017). Benzodiazepines and Z-drugs: An updated review of major adverse outcomes reported on in epidemiologic research. Drugs RD, 17, 493-507.
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Research, 28, 193-213.
Casati, A., Sedefov, R., & Pfeiffer-Gerschel, T. (2012). Misuse of medicines in the European Union: A systematic review of the literature. European Addiction Research, 18, 228-245.
Chan-Chee, C., Bayon, V., Bloch, J., Beck, F., Giordanella, J.-P., & Leger, D. (2011). Epidemiology of insomnia in France. Revue d’épidémiologie Santé Publique, 59, 409-422.
Davidson, J. R., Dickson, C., & Han, H. (2019). Cognitive behavioural treatment for insomnia in primary care: A systematic review of sleep outcomes. British Journal of General Practice, 69, e657-e664.
Edinger, J. D., & Wohlgemuth, W. K. (2001). Psychometric comparisons of the standard and abbreviated DBAS-10 versions of the dysfunctional beliefs and attitudes about sleep questionnaire. Sleep Medicine, 2, 493-500.
Glass, J., Lanctôt, K. L., Herrmann, N., Sproule, B. A., & Busto, U. E. (2005). Sedative hypnotics in older people with insomnia: Meta-analysis of risks and benefits. Bitish Medical Journal, 331, 1169.
IPSOS Santé, Caisse Nationale de l’Assurance Maladie des Travailleurs Salariés. (C.N.A.M.T.S.) (2005). Le rapport des Français et des Européens à l’ordonnance et aux médicaments. Paris, France: Cnamts.
Kellerman, S. E., & Herold, J. (2001). Physician response to surveys. A review of the literature. American Journal of Preventive Medicine, 20, 61-67.
Leger, D., Guilleminault, C., Dreyfus, J. P., Delahaye, C., & Paillard, M. (2000). Prevalence of insomnia in a survey of 12,778 adults in France. Journal of Sleep Research, 9, 35-42.
Léger, D., Partinen, M., Hirshkowitz, M., Chokroverty, S., & Hedner, J. (2010). EQUINOX (Evaluation of daytime QUality Impairment by Nocturnal awakenings in Outpatient’s eXperience) survey investigators characteristics of insomnia in a primary care setting: EQUINOX survey of 5293 insomniacs from 10 countries. Sleep Medicine, 11, 987-998.
Léger, D., Partinen, M., Hirshkowitz, M., Chokroverty, S., Touchette, E., & Hedner, J. (2010). Daytime consequences of insomnia symptoms among outpatients in primary care practice: EQUINOX international survey. Sleep Medicine, 11, 999-1009.
Letrilliart, L., Supper, I., Schuers, M., & Darmon, D. (2014). ECOGEN: étude des Éléments de la COnsultation en médecine GENérale. Exercer, La Revue Francophone De Médecine Générale, 25, 148-157.
Lu, T.-H., Lee, Y.-Y., Lee, H.-C., & Lin, Y.-M. (2015). Doctor shopping behavior for zolpidem among insomnia patients in Taiwan: A nationwide population-based study. Sleep, 38, 1039-1044.
Montgomery, A. J., Bradley, C., Rochfort, A., & Panagopoulou, E. (2011). A review of self-medication in physicians and medical students. Occupational Medicine, 61, 490-497.
Murphy, Y., Wilson, E., Goldner, E. M., & Fischer, B. (2016). Benzodiazepine use, misuse, and harm at the population level in Canada: A comprehensive narrative review of data and developments since 1995. Clinical Drug Investigation, 36, 519-530.
Norman, J. L., Fixen, D. R., Saseen, J. J., Saba, L. M., & Linnebur, S. A. (2017). Zolpidem prescribing practices before and after food and drug administration required product labeling changes. SAGE Open Medicine, 5, 1-5.
Ohayon, M. M. (2002). Epidemiology of insomnia: What we know and what we still need to learn. Sleep Medicine Review, 6, 97-111.
Ohayon, M. M. (2009). Observation of the natural evolution of insomnia in the American general population. Sleep Medicine Clinics, 4, 87-92.
Ohayon, M. M., & Bader, G. (2010). Prevalence and correlates of insomnia in the Swedish population aged 19-75 years. Sleep Medicine, 11, 980-986.
Ordre National des Médecins (2013). La démographie médicale en région Alsace - Situation en 2013, Retrieved from https://www.conseil-national.medecin.fr/sites/default/files/alsace_2013.pdf
Orriols, L., Philip, P., Moore, N., Castot, A., Gadegbeku, B., Delorme, B., …, Lagarde, E. (2011). Benzodiazepine-like hypnotics and the associated risk of road traffic accidents. Clinical Pharmacology and Therapeutics, 89, 595-601.
Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., & Denberg, T. D. (2016). Clinical guidelines Committee of the American College of Physicians Management of Chronic Insomnia Disorder in Adults: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 165, 125-133.
Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., …, Spiegelhalder, K. (2017). European guideline for the diagnosis and treatment of insomnia. Journal of Sleep Research, 26, 675-700.
Scheepers, R. A., Boerebach, B. C. M., Arah, O. A., Heineman, M. J., & Lombarts, K. M. J. M. H. (2015). A systematic review of the impact of physicians’ occupational well-being on the quality of patient care. International Journal of Behavioral Medicine, 22, 683-698.
Schutte-Rodin, S., Broch, L., Buysse, D., Dorsey, C., & Sateia, M. (2008). Clinical guideline for the evaluation and management of chronic insomnia in adults. Journal of Clinical Sleep Medicine JCSM Official Publication of the American Academy of Sleep Medicine, 4, 487-504.
Scott, A., Jeon, S.-H., Joyce, C. M., Humphreys, J. S., Kalb, G., Witt, J., & Leahy, A. (2011). A randomised trial and economic evaluation of the effect of response mode on response rate, response bias, and item non-response in a survey of doctors. BMC Medical Research Methodology, 11, 126.
Siriwardena, A. N., Apekey, T., Tilling, M., Dyas, J. V., Middleton, H., & Ørner, R. (2010). General practitioners’ preferences for managing insomnia and opportunities for reducing hypnotic prescribing. Journal of Evaluation in Clinical Practice, 16, 731-737.
Soler, J. K., Yaman, H., Esteva, M., Dobbs, F., Asenova, R. S., Katic, M., …, Ungan, M. (2008). Burnout in European family doctors: The EGPRN study. Family Practice, 25, 245-265.

Auteurs

Juliette Chambe (J)

General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France.
Sleep Disorders Center-CIRCSom, University Hospital of Strasbourg Strasbourg, Strasbourg, France.
Institute for Cellular and Integrative Neurosciences, CNRS UPR 3212, Strasbourg, France.

Mio Kobayashi Frisk (M)

Sleep Disorders Center-CIRCSom, University Hospital of Strasbourg Strasbourg, Strasbourg, France.
Institute for Cellular and Integrative Neurosciences, CNRS UPR 3212, Strasbourg, France.

Lea Charton (L)

General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France.

François Lefebvre (F)

Public Health Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France.

Sandrine Will (S)

General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France.

Cédric Rat (C)

General Medicine Department, Faculty of Medicine, INSERM U892-CNRS U6299-CRCNA, Nantes, France.

Patrice Bourgin (P)

Sleep Disorders Center-CIRCSom, University Hospital of Strasbourg Strasbourg, Strasbourg, France.
Institute for Cellular and Integrative Neurosciences, CNRS UPR 3212, Strasbourg, France.

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