RECRUITING

Enhancing Hypnotic Medication Discontinuation in Primary Care

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

Many individuals with insomnia seek treatment in primary care settings, where they often receive prescription hypnotic medications as their first and sometimes only treatment. However, extended use of these medications can lead to reliance and increased health risks, such as falls and cognitive impairments. While evidence-based approaches like physician-supervised medication tapering exist, they're not widely available in primary care. Most primary care providers are willing to explore non-drug treatments like cognitive behavioral therapy for insomnia (CBTI), but accessing such treatments can be challenging outside of specialized sleep centers. This gap between research and practice underscores the need for cost-effective interventions to manage insomnia and help patients reduce their reliance on hypnotics in primary care. In response to this need, the project aims to conduct a large randomized trial comparing a combined digital CBT (dCBTI) and medication tapering intervention with medication tapering alone. We'll recruit 430 patients reliant on hypnotics from 8-10 primary care clinics affiliated with the University of Colorado Medical School. The main goal is to assess the effectiveness of dCBTI+SMT compared to SMT alone in reducing hypnotic use and improving insomnia symptoms. Additionally, we'll evaluate factors affecting the adoption and implementation of these interventions at the patient, provider, and system levels. This information will inform future implementation strategies to disseminate effective treatments in primary care. Furthermore, we'll gather data to identify which patients benefit most from dCBTI+SMT. Overall, this study will provide valuable insights into the feasibility, clinical utility, and acceptability of these interventions in managing insomnia and reducing reliance on hypnotic medications in primary care. Ultimately, this project represents a crucial first step toward making accessible and cost-effective strategies available to improve the quality of life for millions of chronic users of sleep aids.

Official Title

Enhancing Hypnotic Medication Discontinuation in Primary Care Through Supervised Medication Tapering and Digital Cognitive Behavioral Insomnia Therapy

Quick Facts

Study Start:2025-01-01
Study Completion:2029-06-30
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT06435520

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:21 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * a history of extended (\> 6 consecutive months) and frequent (\>5 nights/week on average) use of benzodiazepine (BZD) or non-BZD hypnotic medications;
  2. * a desire to decrease/eliminate hypnotic use;
  3. * a history of insomnia that meets DSM-560 criteria for insomnia disorder; and
  4. * willingness to provide written informed consent to participate.
  1. * a lifetime diagnosis of any psychotic disorder, suicide attempts, or bipolar disorder;
  2. * presence of an unstable, untreated, or terminal major medical or psychiatric disorder;
  3. * alcohol or drug abuse within the past year;
  4. * current use of a BZD for another disorder in addition to insomnia (e.g., seizure disorder, restless leg syndrome, anxiety disorder);
  5. * pregnancy;
  6. * significant cognitive impairment as suggested by a score of ≤ 24 on the Folstein Mini-Mental State Examination (MMSE);
  7. * current use of medications known to cause insomnia (e.g., high dose corticosteroids);
  8. * untreated comorbid sleep disorders;
  9. * use of a sedating antidepressant or antipsychotic medication solely for sleep; and
  10. * consuming \>2 alcoholic beverages/day ≥5 times/week or any use of marijuana ≥5 times/week.

Contacts and Locations

Study Contact

RJ Johnson, MA
CONTACT
303-398-1058
chp@njhealth.org

Study Locations (Sites)

National Jewish Health
Denver, Colorado, 80206
United States

Collaborators and Investigators

Sponsor: National Jewish Health

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2025-01-01
Study Completion Date2029-06-30

Study Record Updates

Study Start Date2025-01-01
Study Completion Date2029-06-30

Terms related to this study

Additional Relevant MeSH Terms

  • Insomnia
  • Hypnotic Dependence