A cross-sectional study recently conducted in the US has investigated whether the timing of primary care appointments is associated with aspects of physician’s decision-making regarding opioid prescribing for pain. Time pressure later in the day and/or appointments running behind schedule may contribute to doctors prescribing opioids more frequently, yet little objective evidence currently exists to clarify this possibility. This study examined 678,319 primary care appointments and involved 642,262 patients (61.1% female) who had new painful ailments and had not been prescribed opioids within the past 12 months. As the workday proceeded, a 33% increase in opioid prescription was observed when comparing the 1st-3rd appointments of the day to those towards the end of consulting. Similarly, when appointments were running behind schedule, this resulted in a 17% increase in opioid prescribing comparing to when appointments were running only 0-9 minutes late. This trend was not observed when NSAIDs were prescribed or when physiotherapy was suggested. The results of the study suggest that opioid prescribing decisions are influenced by appointments which are behind schedule or later in the day, which may have implications in public health and quality development efforts in the clinical setting. Read the full details of the study here.

Contributed by Australian Medication Safety Services Associate – Isabella Singh