Doctors tend to write more prescriptions as the work day progresses, a new study finds.
The study was conducted by researchers from Brigham and Women's Hospital. The researchers noted that doctors tend to make inappropriate choices more likely later in the day and often prescribe unnecessary antibiotics for acute respiratory infections (ARI).
"Clinic is very demanding and doctors get worn down over the course of their clinic sessions," explained Jeffrey A. Linder, MD, MPH, a physician and researcher in the Division of General Medicine and Primary Care at BWH and lead author of this study, in a press statement. "In our study we accounted for patients, the diagnosis and even the individual doctor, but still found that doctors were more likely to prescribe antibiotics later in their clinic session."
For the study, researchers analyzed data for patient visits to 23 different primary care practices over the course of 17 months. They used billing codes, visit diagnoses and EHRs (electronic health records) to identify visit times, antibiotic prescriptions and chronic illnesses. They analyzed over 21-thousand ARI visits by adults, which occurred during two four-hour sessions, 8a.m. to noon and 1p.m. to 5p.m.
The data revealed that doctors tend to prescribe more antibiotic as the day passes.
"This corresponds to about 5 percent more patients receiving antibiotics at the end of a clinic session compared to the beginning," explained Linder. "Remedies for this problem might include different schedules, shorter sessions, more breaks or maybe even snacks."
Findings of the study were published online in the journal JAMA Internal Medicine. The study was funded by the National Institutes of Health/National Institute on Aging.
