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http://hdl.handle.net/1893/36354
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DC Field | Value | Language |
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dc.contributor.author | Maier, Mona | en_UK |
dc.contributor.author | Powell, Daniel | en_UK |
dc.contributor.author | Harrison, Christopher | en_UK |
dc.contributor.author | Gordon, Julie | en_UK |
dc.contributor.author | Murchie, Peter | en_UK |
dc.contributor.author | Allan, Julia L | en_UK |
dc.date.accessioned | 2024-10-17T00:07:31Z | - |
dc.date.available | 2024-10-17T00:07:31Z | - |
dc.date.issued | 2024-08 | en_UK |
dc.identifier.uri | http://hdl.handle.net/1893/36354 | - |
dc.description.abstract | Background General practitioners (GPs) make numerous care decisions throughout their workdays. Extended periods of decision making can result in decision fatigue, a gradual shift toward decisions that are less cognitively effortful. This study examines whether observed patterns in GPs’ prescribing decisions are consistent with the decision fatigue phenomenon. We hypothesized that the likelihood of prescribing frequently overprescribed medications (antibiotics, benzodiazepines, opioids; less effortful to prescribe) will increase and the likelihood of prescribing frequently underprescribed medications (statins, osteoporosis medications; more effortful to prescribe) will decrease over the workday. Methods This study used nationally representative primary care data on GP-patient encounters from the Bettering the Evaluation and Care of Health program from Australia. The association between prescribing decisions and order of patient encounters over a GP’s workday was assessed with generalized linear mixed models accounting for clustering and adjusting for patient, provider, and encounter characteristics. Results Among 262,456 encounters recorded by 2,909 GPs, the odds of prescribing antibiotics significantly increased by 8.7% with 15 additional patient encounters (odds ratio [OR] = 1.087; confidence interval [CI] = 1.059–1.116). The odds of prescribing decreased significantly with 15 additional patient encounters by 6.3% for benzodiazepines (OR = 0.937; CI = 0.893–0.983), 21.9% for statins (OR = 0.791; CI = 0.753–0.831), and 25.0% for osteoporosis medications (OR = 0.750; CI = 0.690–0.814). No significant effects were observed for opioids. All findings were replicated in confirmatory analyses except the effect of benzodiazepines. Conclusions GPs were increasingly likely to prescribe antibiotics and were less likely to prescribe statins and osteoporosis medications as the workday wore on, which was consistent with decision fatigue. There was no convincing evidence of decision fatigue effects in the prescribing of opioids or benzodiazepines. These findings establish decision fatigue as a promising target for optimizing prescribing behavior. | en_UK |
dc.language.iso | en | en_UK |
dc.publisher | SAGE Publications | en_UK |
dc.relation | Maier M, Powell D, Harrison C, Gordon J, Murchie P & Allan JL (2024) Assessing Decision Fatigue in General Practitioners’ Prescribing Decisions Using the Australian BEACH Data Set. <i>Medical Decision Making</i>, 44 (6), pp. 627-640. https://doi.org/10.1177/0272989x241263823 | en_UK |
dc.rights | © The Author(s) 2024. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). | en_UK |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_UK |
dc.subject | decision fatigue | en_UK |
dc.subject | drug prescribing | en_UK |
dc.subject | general practitioners | en_UK |
dc.subject | clinical decision-making | en_UK |
dc.subject | practice patterns | en_UK |
dc.subject | physicians | en_UK |
dc.title | Assessing Decision Fatigue in General Practitioners’ Prescribing Decisions Using the Australian BEACH Data Set | en_UK |
dc.type | Journal Article | en_UK |
dc.identifier.doi | 10.1177/0272989x241263823 | en_UK |
dc.identifier.pmid | 39056336 | en_UK |
dc.citation.jtitle | Medical Decision Making | en_UK |
dc.citation.issn | 1552-681X | en_UK |
dc.citation.issn | 0272-989X | en_UK |
dc.citation.volume | 44 | en_UK |
dc.citation.issue | 6 | en_UK |
dc.citation.spage | 627 | en_UK |
dc.citation.epage | 640 | en_UK |
dc.citation.publicationstatus | Published | en_UK |
dc.citation.peerreviewed | Refereed | en_UK |
dc.type.status | VoR - Version of Record | en_UK |
dc.contributor.funder | The Royal Society of Edinburgh | en_UK |
dc.author.email | julia.allan@stir.ac.uk | en_UK |
dc.citation.date | 26/07/2024 | en_UK |
dc.contributor.affiliation | University of Aberdeen | en_UK |
dc.contributor.affiliation | University of Aberdeen | en_UK |
dc.contributor.affiliation | University of Sydney | en_UK |
dc.contributor.affiliation | University of Sydney | en_UK |
dc.contributor.affiliation | University of Aberdeen | en_UK |
dc.contributor.affiliation | Psychology | en_UK |
dc.identifier.isi | WOS:001278062200001 | en_UK |
dc.identifier.scopusid | 2-s2.0-85199983106 | en_UK |
dc.identifier.wtid | 2055672 | en_UK |
dc.contributor.orcid | 0000-0001-7287-8363 | en_UK |
dc.date.accepted | 2024-07-02 | en_UK |
dcterms.dateAccepted | 2024-07-02 | en_UK |
dc.date.filedepositdate | 2024-10-09 | en_UK |
rioxxterms.apc | not required | en_UK |
rioxxterms.type | Journal Article/Review | en_UK |
rioxxterms.version | VoR | en_UK |
local.rioxx.author | Maier, Mona| | en_UK |
local.rioxx.author | Powell, Daniel| | en_UK |
local.rioxx.author | Harrison, Christopher| | en_UK |
local.rioxx.author | Gordon, Julie| | en_UK |
local.rioxx.author | Murchie, Peter| | en_UK |
local.rioxx.author | Allan, Julia L|0000-0001-7287-8363 | en_UK |
local.rioxx.project | Project ID unknown|The Royal Society of Edinburgh| | en_UK |
local.rioxx.freetoreaddate | 2024-10-15 | en_UK |
local.rioxx.licence | http://creativecommons.org/licenses/by/4.0/|2024-10-15| | en_UK |
local.rioxx.filename | maier-et-al-2024-assessing-decision-fatigue-in-general-practitioners-prescribing-decisions-using-the-australian-beach.pdf | en_UK |
local.rioxx.filecount | 1 | en_UK |
local.rioxx.source | 1552-681X | en_UK |
Appears in Collections: | Economics Journal Articles |
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