Effect of a pharmacistled sleep hygiene coaching program on medication possession ratio of sedatives used for insomnia

Abstract

Objective: The purpose of this study is to develop and implement a sleep hygiene coaching program at a community pharmacy, and determine whether participation in this coaching program can reduce non-benzodiazepine benzodiazepine receptor agonistic modulator (nBZD) use and improve sleep quality. Methods: The benefits of sleep hygiene coaching services have been demonstrated in primary care settings by nurses and counselors. However, a pharmacist-provided intervention has not been studied. Pharmacy staff at two sites of a grocery store chain pharmacy will identify patients >18 years old using nBZDs during the dispensing process. Patients will be excluded if they are pregnant. The initial appointment will consist of a pharmacist delivering an educational program to a group of patients covering general sleep and insomnia education, as well as nonpharmacological techniques for improving sleep quality. The pharmacist will follow up with patients individually up to four times via phone call or in the pharmacy every 2 to 4 weeks. During follow-up, pharmacists will continue to coach and motivate patients to make behavioral changes, and collect sleep quality data using patient recall, sleep diaries, and the validated Pittsburgh Sleep Quality Index (PSQI). Each intervention patient will be matched with two or more controls based on age, gender, dose, and type of nBZD. The validated Medication Possession Ratio will be used to estimate the amount of sedative medication patients use during the intervention period. A two-tailed t test will be used to determine if there is a significant change in nBZD use among intervention patients compared with controls. Descriptive statistics will be used to analyze changes in sleep quality and number of hours slept (from PSQI or sleep diary), and number of awakenings (from sleep diaries or patient recall) in the intervention group.