Evidence map›Paper›PMID 34007630›Full record

ArticleInnovations in pharmacy2020

Impact of Pharmacist-Led Cognitive Behavioural Therapy for Chronic Insomnia.

Joshua Nurkowski, Habiba Elshorbagy, Katelyn Halpape, Karen Jensen, Darcy A Lamb, Eric Landry, Alfred Remillard, Derek Jorgenson

Open access · diamondAbstract read
In one paragraph

Article in Innovations in pharmacy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 11 citations in OpenAlex.

  1. Review
  2. Lifting lockdown COVID19 restrictions: What can pharmacists do as the world wakes up?Exploratory research in clinical and social pharmacy · 2021
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Joshua NurkowskiCollege of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK.
Habiba ElshorbagySaskatchewan Health Authority, Saskatoon, SK.
Katelyn HalpapeCollege of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK.
Karen JensenCollege of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK.
Darcy A LambSaskatchewan Health Authority, Saskatoon, SK.
Eric LandryCollege of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK.
Alfred RemillardCollege of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK.
Derek JorgensonCollege of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK.
University of Saskatchewan · CASaskatchewan Health Authority · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic insomnia is a common medical condition that negatively impacts quality of life and daytime function. Access to the first-line treatment for insomnia, cognitive behavioural therapy (CBT-i), is limited. Pharmacists are well positioned to provide this service, but evidence regarding pharmacist delivered CBT-i is sparse. The aim of this study was to evaluate the effectiveness of CBT-i delivered by pharmacists practicing in an outpatient clinic setting.

methodsThis study was a retrospective chart audit of adult patients with chronic insomnia who received CBT-i from a pharmacist at one of two outpatient clinics in Canada. The primary endpoints were the differences between patient self-reported sleep diary parameters and utilization of hypnotic medications before and after CBT-i was delivered. The differences in patient reported sleep parameters were compared using Wilcoxon Signed Rank test and paired samples t-test and changes in hypnotic utilization was compared using McNemar Chi-square test.

results183 patients were referred for CBT-i and attended an initial appointment with a pharmacist. Of these, 105 did not receive the CBT-i. This resulted in 78 patients who met the inclusion criteria. Changes in sleep diary parameters were all statistically significantly improved after patients received CBT-i, except for total sleep time. Hypnotic medication use was also reduced. At baseline, 71.8% (n=56/78) of patients were taking one or more hypnotic medications compared to 52.6% (n=41/78) after CBT-i (p=0.0003). DISCUSSION: The results of this study provide preliminary evidence that pharmacists working in an outpatient clinic setting may be able to effectively deliver CBT-i for patients with chronic insomnia. The external validity of these results is limited by the observational study design and the inclusion of pharmacists practicing in outpatient clinics, which is not the setting where most pharmacists currently practice.

conclusionThis observational study found improvements in sleep quality and efficiency, as well as, a reduction in hypnotic medication use, in patients who received CBT-i from pharmacists practicing in an outpatient clinic setting. Future randomized, controlled trials should evaluate the impact of CBT-i in a larger sample of patients, provided by pharmacists practicing in both outpatient clinics and community pharmacies.

Indexed as

cognitive behavioural therapyinsomniapharmacy practiceprimary care

Identifiers

PMID34007630
PMCPMC8075143
OpenAlexW3047577712

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.