Imperial College London
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Dr Lindsay H. Dewa

Faculty of Medicine, School of Public Health

Advanced Research Fellow
 
 
 
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Contact

 

+44 (0)20 7594 0815l.dewa

 
 
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Location

 

609School of Public HealthWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Dewa:2018:10.1136/bmjopen-2018-022406,
author = {Dewa, LH and Hassan, L and Shaw, J and Senior, J},
doi = {10.1136/bmjopen-2018-022406},
journal = {BMJ Open},
title = {The design of a treatment pathway for insomnia in prison settings in England: a modified Delphi study},
url = {http://dx.doi.org/10.1136/bmjopen-2018-022406},
volume = {8},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective: Insomnia is highly prevalent in prisoners and is a risk factor for poor mental well-being, depression, suicidality and aggression, all common concerns in this vulnerable population. Improving sleep management options in prison offers the potential to impact positively on a number of these common risk factors. The study aim was to design a treatment pathway for insomnia in prisons informed by stakeholders with professional or lived experience of insomnia and prison-based interventions.Design: A modified Delphi technique, adapted to the stakeholder (either receiving controlled feedback online or face to face on a series of statements), was used over three rounds to gain consensus on a final treatment pathway design.Participants: Academic sleep researchers, prison staff and prisoners were invited to develop the treatment pathway.Results: Fifteen stakeholders took part in round 1 and thirteen in round 2. There were six statements of contention that comprised concerns over the inclusion of sleep observations, sleep restriction therapy and promethazine. Consensus was high (>80%). Thirteen stakeholders agreed the final pathway in round 3. The final treatment pathway comprised a standardised stepped-care approach for insomnia in prison populations. The pathway resulted in five main stages: (1) transition from community; (2) detection and assessment; (3) treatment for short-term insomnia; (4) treatment for long-term insomnia and (5) transition from prison to community or another establishment.Conclusions: The treatment pathway is designed to promote early detection of insomnia, potentially reducing unnecessary prescriptions and medication trading, misuse and diversion in the prison setting. It should make a substantial difference in reducing the large number of sleep complaints and positively impact on prisoners, staff and the prison environment. Specifically, improving sleep should have a positive impact on prisoners’ mental and physical well-being and a
AU  - Dewa,LH
AU  - Hassan,L
AU  - Shaw,J
AU  - Senior,J
DO  - 10.1136/bmjopen-2018-022406
PY  - 2018///
SN  - 2044-6055
TI  - The design of a treatment pathway for insomnia in prison settings in England: a modified Delphi study
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2018-022406
UR  - http://hdl.handle.net/10044/1/62599
VL  - 8
ER  -
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