JMIR Publications

ABSTRACT

Background:

Sleepio, a digital therapeutic offering digital cognitive behavioural therapy for insomnia, has been recommended by the National Institute for Health and Care Excellence (NICE) in the United Kingdom as an alternative to offering sleep hygiene or sleeping pills. However, understanding of the referral behaviour of general practitioners (GPs) regarding Sleepio is lacking.

Objective:

The aim of this study was to investigate the feasibility of using an intervention targeting GPs in Scotland to increase referrals of insomnia patients to Sleepio.

Methods:

GPs working in primary care in Scotland were invited to join the study. During the intervention, GPs reviewed an orientation on using Sleepio and received a visual reminder midway through the intervention. The primary outcome was the number of Sleepio referrals every two weeks over two months. The secondary outcome was the change in the GPs’ reported confidence level that Sleepio will be successful in reducing patients’ insomnia symptoms, and confidence in recommending Sleepio to patients.

Results:

Of the 23 GPs who joined the study, 16 completed all stages. The total number of Sleepio referrals in two months was 96 for all 16 GPs. In the first two weeks of the intervention, the mean referral rate to Sleepio was 22.4% for all 16 GPs, but this rate increased to 45% by the end of week 8. A repeated measures analysis indicated there was no statistically significant difference in GPs referral rates across four data points. GPs reported confidence level in recommending Sleepio increased significantly (Z = -3.436, P < 0.01), from a mean of 5.44 (somewhat confident) to 8.13 (very confident).

Conclusions:

This study explored the feasibility and impact of an intervention aimed at supporting GPs’ to refer patients with insomnia to the digital therapeutic, Sleepio. Improvements were seen in GP-reported confidence levels at recommending Sleepio. A large-scale intervention and a longer study duration could provide useful information concerning how long the intervention effect on GPs’ behaviour towards Sleepio referrals might be sustained.