Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/36354
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dc.contributor.authorMaier, Monaen_UK
dc.contributor.authorPowell, Danielen_UK
dc.contributor.authorHarrison, Christopheren_UK
dc.contributor.authorGordon, Julieen_UK
dc.contributor.authorMurchie, Peteren_UK
dc.contributor.authorAllan, Julia Len_UK
dc.date.accessioned2024-10-17T00:07:31Z-
dc.date.available2024-10-17T00:07:31Z-
dc.date.issued2024-08en_UK
dc.identifier.urihttp://hdl.handle.net/1893/36354-
dc.description.abstractBackground 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.isoenen_UK
dc.publisherSAGE Publicationsen_UK
dc.relationMaier 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/10.1177/0272989x241263823en_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.urihttp://creativecommons.org/licenses/by/4.0/en_UK
dc.subjectdecision fatigueen_UK
dc.subjectdrug prescribingen_UK
dc.subjectgeneral practitionersen_UK
dc.subjectclinical decision-makingen_UK
dc.subjectpractice patternsen_UK
dc.subjectphysiciansen_UK
dc.titleAssessing Decision Fatigue in General Practitioners’ Prescribing Decisions Using the Australian BEACH Data Seten_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.1177/0272989x241263823en_UK
dc.identifier.pmid39056336en_UK
dc.citation.jtitleMedical Decision Makingen_UK
dc.citation.issn1552-681Xen_UK
dc.citation.issn0272-989Xen_UK
dc.citation.volume44en_UK
dc.citation.issue6en_UK
dc.citation.spage627en_UK
dc.citation.epage640en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.contributor.funderThe Royal Society of Edinburghen_UK
dc.author.emailjulia.allan@stir.ac.uken_UK
dc.citation.date26/07/2024en_UK
dc.contributor.affiliationUniversity of Aberdeenen_UK
dc.contributor.affiliationUniversity of Aberdeenen_UK
dc.contributor.affiliationUniversity of Sydneyen_UK
dc.contributor.affiliationUniversity of Sydneyen_UK
dc.contributor.affiliationUniversity of Aberdeenen_UK
dc.contributor.affiliationPsychologyen_UK
dc.identifier.isiWOS:001278062200001en_UK
dc.identifier.scopusid2-s2.0-85199983106en_UK
dc.identifier.wtid2055672en_UK
dc.contributor.orcid0000-0001-7287-8363en_UK
dc.date.accepted2024-07-02en_UK
dcterms.dateAccepted2024-07-02en_UK
dc.date.filedepositdate2024-10-09en_UK
rioxxterms.apcnot requireden_UK
rioxxterms.typeJournal Article/Reviewen_UK
rioxxterms.versionVoRen_UK
local.rioxx.authorMaier, Mona|en_UK
local.rioxx.authorPowell, Daniel|en_UK
local.rioxx.authorHarrison, Christopher|en_UK
local.rioxx.authorGordon, Julie|en_UK
local.rioxx.authorMurchie, Peter|en_UK
local.rioxx.authorAllan, Julia L|0000-0001-7287-8363en_UK
local.rioxx.projectProject ID unknown|The Royal Society of Edinburgh|en_UK
local.rioxx.freetoreaddate2024-10-15en_UK
local.rioxx.licencehttp://creativecommons.org/licenses/by/4.0/|2024-10-15|en_UK
local.rioxx.filenamemaier-et-al-2024-assessing-decision-fatigue-in-general-practitioners-prescribing-decisions-using-the-australian-beach.pdfen_UK
local.rioxx.filecount1en_UK
local.rioxx.source1552-681Xen_UK
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