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Assessing Decision Fatigue in General Practitioners' Prescribing Decisions Using the Australian BEACH Data Set
Mona Maier1, Daniel Powell1, Christopher Harrison2
1Health Psychology, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Summary
General practitioners (GPs) showed increased antibiotic prescribing and decreased statin/osteoporosis medication prescribing as their workday progressed, consistent with decision fatigue. This highlights decision fatigue as a target for optimizing prescribing behavior.
Area of Science:
- Medical Decision Making
- Clinical Pharmacy
- Health Services Research
Background:
- General practitioners (GPs) face numerous daily decisions, potentially leading to decision fatigue.
- Decision fatigue can cause a shift towards less cognitively demanding choices.
- This study investigated if GP prescribing patterns reflect decision fatigue.
Purpose of the Study:
- To examine if GPs' prescribing decisions change over the workday due to decision fatigue.
- To test the hypothesis that prescribing overused medications increases while underused medications decrease as the workday progresses.
Main Methods:
- Analysis of nationally representative primary care data from Australia (Bettering the Evaluation and Care of Health program).
- Utilized generalized linear mixed models to assess the association between prescribing decisions and encounter order.
- Adjusted for patient, provider, and encounter characteristics.
Main Results:
- Prescribing antibiotics increased by 8.7% with 15 additional patient encounters (OR=1.087).
- Prescribing of statins decreased by 21.9% (OR=0.791) and osteoporosis medications by 25.0% (OR=0.750) with 15 additional encounters.
- No significant effects observed for opioids; mixed results for benzodiazepines.
Conclusions:
- GP prescribing patterns align with decision fatigue, with increased antibiotic and decreased statin/osteoporosis medication prescriptions later in the workday.
- Decision fatigue appears to influence prescribing of certain medication classes.
- Findings suggest decision fatigue is a modifiable factor for improving guideline-compliant prescribing.
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