7 Implementation and audit
7.1 NHS organisations and clinicians who prescribe treatment for people with insomnia should review their current practice and policies and the current patterns of prescribing hypnotic drugs, as reported in high-level performance indicators, to take account of the guidance set out in Section 1.
7.2 Local guidelines, protocols or care pathways that refer to the care of people with insomnia should incorporate the guidance in Section 1.
7.3 To measure compliance locally with the guidance, the following criteria could be used. Further details on suggestions for audit are presented in Appendix C.
7.3.1 Hypnotic drug therapy is used for the management of severe insomnia interfering with normal daily life only after due consideration of the use of non-pharmacological measures.
7.3.2 When hypnotic drug therapy is used, the drugs are prescribed for short periods of time only, in strict accordance with the licensed indications.
7.3.3 When hypnotic drug therapy with shorter-acting benzodiazepine hypnotics, zaleplon, zolpidem or zopiclone, is prescribed, the drug with the lowest purchase cost is chosen.
7.3.4 A patient is switched from one of these hypnotic drugs to another only if he or she experiences adverse effects considered to be directly related to a specific agent.
7.3.5 A patient who has not responded to one of these hypnotic drugs is not prescribed any of the others.