TY - JOUR
T1 - Implementation and Effectiveness of Cognitive Behavioral Therapy for Insomnia in Geriatric Primary Care
AU - Hinrichsen, Gregory A.
AU - Leipzig, Rosanne M.
N1 - Funding Information:
This work was supported by Agencia Nacional de Promoción Científica y Tecnológica (ANPCyT-MINCyT), grants: PICT-2018–4275 to JSLC and PICT-2018–4285 to LGG; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET); Instituto Nacional de Genética Médica Populacional (INAGEMP) [Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) grant 465549/2014–4; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), grant 88887.136366/2017–00; and Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (FAPERGS), grant 17/2551–0000521-0]; and from Fundo de Incentivo à Pesquisa e Eventos do Hospital de Clínicas de Porto Alegre (FIPE/HCPA), grant 17–0445. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2022 Taylor & Francis Group, LLC.
PY - 2022
Y1 - 2022
N2 - Objectives: We evaluated a plan for implementation and effectiveness of cognitive behavioral therapy for insomnia (CBT-I) in geriatric primary care by a geropsychologist. Methods: The flow of referrals to a geropsychologist was tracked and, among those eligible and interested in participating, success in deprescribing sleep medications and the effectiveness of CBT-I were documented. Results: Seventy patients were referred for evaluation of whom 62 were eligible for CBT-I; 34 began CBT-I and 29 completed a full course of treatment. Almost two-thirds of treatment completers were the “old old” (76–84 years) and “oldest old” (85–93 years) with multiple medical problems. Most treatment completers taking sleep medications had them deprescribed at the beginning of treatment and, one year after treatment, did not have them re-prescribed. After CBT-I, two-thirds of patients met the insomnia severity index criteria for response; and three-fifths for remission from insomnia. Further, most patients had sustained improvement in their target insomnia symptom(s) and sleep efficiency. Conclusions: CBT-I can be implemented in geriatric primary care with successful deprescribing of sleep medications and meaningful improvement in symptoms of insomnia in a group of older adults of advanced age with multiple medical problems. Clinical Implications: Clinical gerontologists can play an important role in improving late life insomnia.
AB - Objectives: We evaluated a plan for implementation and effectiveness of cognitive behavioral therapy for insomnia (CBT-I) in geriatric primary care by a geropsychologist. Methods: The flow of referrals to a geropsychologist was tracked and, among those eligible and interested in participating, success in deprescribing sleep medications and the effectiveness of CBT-I were documented. Results: Seventy patients were referred for evaluation of whom 62 were eligible for CBT-I; 34 began CBT-I and 29 completed a full course of treatment. Almost two-thirds of treatment completers were the “old old” (76–84 years) and “oldest old” (85–93 years) with multiple medical problems. Most treatment completers taking sleep medications had them deprescribed at the beginning of treatment and, one year after treatment, did not have them re-prescribed. After CBT-I, two-thirds of patients met the insomnia severity index criteria for response; and three-fifths for remission from insomnia. Further, most patients had sustained improvement in their target insomnia symptom(s) and sleep efficiency. Conclusions: CBT-I can be implemented in geriatric primary care with successful deprescribing of sleep medications and meaningful improvement in symptoms of insomnia in a group of older adults of advanced age with multiple medical problems. Clinical Implications: Clinical gerontologists can play an important role in improving late life insomnia.
KW - Dissemination
KW - deprescribing
KW - evidence-based
KW - psychotherapy
UR - http://www.scopus.com/inward/record.url?scp=85136167088&partnerID=8YFLogxK
U2 - 10.1080/07317115.2022.2104675
DO - 10.1080/07317115.2022.2104675
M3 - Article
AN - SCOPUS:85136167088
SN - 0731-7115
JO - Clinical Gerontologist
JF - Clinical Gerontologist
ER -