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 19th to 21st 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.