Systematic Review of Antihistamine Prescribing Guidelines for Insomnia in Adults: A Comparative Study between the UK and Saudi Arabia Professional Practices

Abstract

Background: This systematic review examines the guidelines for prescribing antihistamines to adult patients with insomnia in the UK and Saudi Arabia. It highlights the professional differences between the UK's National Institute for Health and Care Excellence (NICE), which emphasizes non-pharmacological treatments and patient safety, and the less stringent, pharmacologically inclined guidelines in Saudi Arabia, influenced by cultural and regulatory factors. Aim: The study aims to evaluate and compare the professional guidelines for prescribing antihistamines to adult patients with insomnia in the UK and Saudi Arabia, assessing their impact on patient safety and clinical outcomes, and identifying the factors influencing these practices. Methods: A thorough literature search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, utilizing databases such as PubMed, Scopus, Web of Science, and the Cochrane Library. The review included randomized controlled trials (RCTs), cohort studies, and cross-sectional studies that examined the effectiveness and safety of antihistamines in treating insomnia in adult patients within these regions. Systematic data extraction focused on key study characteristics such as study design, drug used, dosage, and main findings. Results: The review identified significant differences in prescribing practices between the two regions. UK guidelines are robust, advocating for initial non-pharmacological interventions, while Saudi guidelines are noted for their lack of specificity, potentially leading to inconsistent prescribing and increased risks for adult patients. The distinct roles of pharmacists in each region also reflect differing approaches to medication dispensing and management. Conclusion: The findings highlight the need for Saudi Arabia to refine its clinical guidelines to align more closely with evidence-based practices like those in the UK to enhance patient safety and treatment efficacy. Both countries could benefit from enhanced professional education and stricter regulatory oversight to improve antihistamine prescribing practices for treating insomnia in adults.