P062 Development of a new Stepped Care approach to Insomnia treatment in a public health system

Abstract Introduction Challenges exist in managing the clinical need for Insomnia treatment in the public health system. Traditional insomnia treatments can inflate wait times and are becoming unsustainable in the face of rising patient acuity/demand. The objective of this project is to develop a new Stepped Care (SC) treatment approach within a large tertiary hospital sleep disorders service. Method Online surveys on experiences and perspectives of existing and novel insomnia therapies were sent to 121 dyads (patients and their GPs) who had accessed the Sleep Psychology service between January 2021 and June 2023, as well as 41 multi-disciplinary staff from the Sleep Disorder Centre. A consensus group workshop was conducted to co-design the new SC treatment approach, which was informed by consumer and stakeholder feedback. Results Most GPs were familiar with online therapies, but few prescribed. Similarly, most patients who completed an online program found it helpful. The consensus group data revealed a preference for patient allocation to one of the following Steps based on clinical presentation/acuity: Level1: self-administered CBTi via validated online program; Level2: supervised small group CBTi delivered by psychology intern; Level3: 1:1 supervised CBTi treatment with psychology intern; and Level4: 1:1 intensive CBTi with an experienced psychologist. Discussion Stepped Care (SC) treatment models are flexible, allow intervention adaption based on patient treatment response, as well as offer service efficiencies in a public health setting.