Journal of General Internal Medicine

, Volume 33, Issue 11, pp 1828–1830 | Cite as

Time of Day is Associated with Opioid Prescribing for Low Back Pain in Primary Care

  • Lindsey M. Philpot
  • Bushra A. Khokhar
  • Daniel L. Roellinger
  • Priya Ramar
  • Jon O. EbbertEmail author
Concise Research Reports


An estimated 29% of US adults have an episode of low back pain (LBP) over a 3-month period.1 Opioids may be effective for short-term LBP pain relief, but evidence for long-term efficacy is limited.

The timing of healthcare provision may influence process measures and clinical outcomes. In primary care, an increased likelihood of antibiotic prescribing for acute respiratory infection has been observed with appointments later in a clinic session.2 No previous studies have evaluated the impact of appointment time of day on the provision of opioids to patients with LBP.


We used administrative billing data, prescription data, and outpatient appointment scheduling data identifying all patients with a primary care provider appointment for LBP between January 1, 2015, and December 31, 2015, at Mayo Clinic in Rochester, Minnesota. Patient visits were sampled from administrative billing data using International Classification of Diseases, 9th Revision (ICD-9) and 10th...


back pain pain ambulatory care physician behavior 


Funding Information

This study was funded by the Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery and the Mayo Clinic College of Medicine.

Compliance with Ethical Standards

The Mayo IRB reviewed and approved this research.

Conflict of Interest

LMP reports funding from GSK for research not related to the current work. No other authors have conflicts of interest to report.


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Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • Lindsey M. Philpot
    • 1
  • Bushra A. Khokhar
    • 1
  • Daniel L. Roellinger
    • 1
  • Priya Ramar
    • 1
  • Jon O. Ebbert
    • 1
    • 2
    Email author
  1. 1.Robert D. and Patricia E. Kern Mayo Clinic Center for the Science of Health Care DeliveryMayo Clinic College of MedicineRochesterUSA
  2. 2.Primary Care Internal Medicine Mayo Clinic College of MedicineRochesterUSA

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