Does appointment time influence primary care opioid prescribing?

Bottom Line:

Physicians at primary care appointments were more likely to prescribe opioids for pain later in the day and as appointments ran more behind schedule, although the absolute difference in the prescribing rate across the day was modest in this analysis of electronic health records. The observational study included 678,319 primary care appointments for patients with a new painful condition who hadn’t received an opioid prescription within the past year. The likelihood that an appointment resulted in an opioid prescription increased from 4% in the first three appointments of the day to 5.3% later on at the 19

^th

to 21

^st

appointments; and from 4.4% for appointments running less than 10 minutes late to 5.2% for appointments at least 60 minutes late. Similar patterns weren’t observed for prescriptions for nonsteroidal anti-inflammatory drugs and referrals to physical therapy. Limitations of the study include other unobserved reasons patients may be prescribed opioids.

(doi:10.1001/jamanetworkopen.2019.10373)

Editor’s Note:

The study includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

###

Media advisory:

To contact corresponding author Hannah T. Neprash, Ph.D., email Sarah Bjorkman at

[email protected]

. The full study is linked to this news release.

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JAMA Network Open

is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.