{Reference Type}: Journal Article
{Title}: Guideline-concordant use of cognitive behavioral therapy for insomnia in the Veterans Health Administration.
{Author}: Pfeiffer PN;Ganoczy D;Zivin K;Gerlach L;Damschroder L;Ulmer CS;
{Journal}: Sleep Health
{Volume}: 9
{Issue}: 6
{Year}: 2023 12 11
{Factor}: 4.207
{DOI}: 10.1016/j.sleh.2023.07.002
{Abstract}: To characterize guideline-concordant use of cognitive behavioral therapy for insomnia vs. sleep medications among Veterans Health Administration patients.<BR>Cognitive behavioral therapy for insomnia was identified from the text of psychotherapy notes within the Veterans Health Administration's electronic medical record. Patients that received first-line cognitive behavioral therapy for insomnia (ie, no prior insomnia treatment) were compared to those who first received a sleep medication in fiscal year 2021.<BR>Among 5,519,016 patients, first-line cognitive behavioral therapy for insomnia was received by 9313 (0.2%) whereas 225,618 (4.1%) were newly prescribed a sleep medication without prior cognitive behavioral therapy for insomnia. Patients over 60 years old and those with substance use disorders were less likely to receive first-line cognitive behavioral therapy for insomnia compared to other patients.<BR>Adherence to practice guidelines to provide cognitive behavioral therapy for insomnia as first-line treatment for insomnia disorder remains a challenge, highlighting the need to better integrate effective implementation strategies within therapist training programs. Targeted strategies may be needed for older patients or those with substance use disorders.