|Improving Primary Care Resources for Effective Sleep Treatment (IPCREST)
|East Midlands Health Innovation and Education Cluster (EMHIEC)
|To encourage GPs to shift away from prescribing hypnotic drugs for treating insomnia in favour Cognitive Behavioural Therapy for Insomnia (CBT-I). It is envisaged that patients themselves will take a more proactive role in managing their condition.
|The evaluation used a mixed methods approach using pre- and post-learning surveys, e-learning usage, analysis of prescribing and prescribing cost data and practitioner interviews.
|Overall, during the period of IPCREST (April 2011 to March 2012), hypnotic and anxiolytic prescribing costs across the East Midlands counties involved above fell over ten percent (10.3 per cent) from £4.34 million in 2010/11 to £3.89 million. The number of prescription items actually increased in all the areas involved in IPCREST (Figures 10 & 11) which, taken together with falling costs, suggests that prescriptions of hypnotic and anxiolytic drugs were dispensed with less expensive products or smaller pack sizes (i.e. fewer tablets per prescription).
|Impact case study
IPCREST aimed to provide effective, patient-centred care to improve sleep quality and quality of life and reduce long-term inappropriate hypnotic prescribing.The innovation was to implement a new system for assessment and psychological treatment for insomnia in primary care. More effective treatment of insomnia is associated with reduced cardiovascular risks (obesity, hypertension) and complications (coronary heart disease), mental health problems (anxiety and depression) as well as work absence; it is also linked to improved function at work, and reduced inappropriate long-term prescribing of hypnotics with their potential for side- effects (daytime sedation, accidents and falls).Better management of insomnia has the potential to improve quality of life, reduce work absence, improve poor function at work (presenteeism) and reduce the substantial economic costs of decreased productivity in service users as well as reducing the costs of long-term hypnotic prescribing (£22 million per annum) and reducing the associated repeat consultations, adverse effects and the potential interactions of hypnotic drugs.
The impact from this work and our research on insomnia and hypnotic drugs more generally is summarised at the REST project website, was presented in a case study to REF2014, Improving the primary care management of insomnia, and publicised in the university research showcase, ‘Improving treatment for insomnia sufferers‘.