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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. Ebbert
Concise Research Reports

INTRODUCTION

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.

METHODS

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...

KEY WORDS

back pain pain ambulatory care physician behavior 

Notes

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.

References

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    Centers for Disease Control and Prevention. Health, United States, 2014 – Individual Charts and Tables: Spreadsheet, PDF, and PowerPoint Files. 2015; https://www.cdc.gov/nchs/hus/contents2014.htm#046. Accessed 1 May 2018.
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    Dai H, Milkman KL, Hofmann DA, Staats BR. The impact of time at work and time off from work on rule compliance: the case of hand hygiene in health care. J Appl Psychol 2015;100(3):846–862.CrossRefGoogle Scholar
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    Kaplan SH, Greenfield S, Gandek B, Rogers WH, Ware JE Jr. Characteristics of physicians with participatory decision-making styles. Ann Intern Med 1996;124(5):497–504.CrossRefGoogle Scholar

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
  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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