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Barriers to insomnia treatment for general physicians in Iran: A mixed-method study

Leeba Rezaie, David Philips, Aaron Fobain, Habibolah Khazaie


Background: Insomnia is a common sleep disorder with adverse consequences on quality of life. Early diagnosis and treatment of insomnia can prevent these consequences. General physicians have an important role in the timely diagnosis and treatment of insomnia. Investigating the barriers that general physicians experience when treating insomnia may improve person-centered clinical care. The present study was designed to identify and analyze these barriers.

Methods: A mixed-methods design was used. General physicians who worked in Kermanshah, Iran, were recruited. Data collection methods included semi-structured interviews and questionnaires. Thematic analysis was used for qualitative data and quantitative data were analyzed using descriptive-analytic statistics.

Results: Barriers to insomnia treatment emerged from patient, physician and social domains. Beliefs about insomnia and concern about treatment were among the barriers in the patient category. Physicians’ attitude and insufficient knowledge of pharmacological and non-pharmacological treatment were common barriers in the physician category. Barriers related to socioeconomic problems and lack of awareness about sleep disorders. Social barriers interacted across domains. Physician reports generally did not differ based on years of work experience.

Conclusion: Barriers to insomnia treatment should be seen in light of the patient, physician and social system. These barriers do not operate in isolation, but interact and influence each other. Comprehensive programs to overcome barriers to insomnia treatment are recommended in the development of person-centered approaches to the management of insomnia.


Barriers, general physicians, insomnia, Iran, mixed method study, person-centered healthcare

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