The presence of "decision fatigue," perhaps unsurprisingly, becomes more pronounced as the day goes on, according to a research letter in JAMA Internal Medicine.
Researchers analyzed and compared EHR records and billing data for patients with acute respiratory infection symptoms who went to primary care practices between 2011 and 2012.
Overall physicians prescribed antibiotics for 44 percent of respiratory infections, and they were 26 percent more likely to prescribe antibiotics in the fourth hour of their shift than in the first hour.
Additionally, physicians prescribed antibiotics for conditions not requiring them (ie. infections caused by viruses such as acute bronchitis and influenza) 30 percent of the time at 1:00 p.m. and 35 percent of the time at 4:00 p.m., according to the study.
"Just as an observation, it kind of makes sense," said Jeffrey Linder, MD, co-author of the research letter, in a Reuters report. "Doctors are human too, and we get tired over the course of the day and tend to make worse-appearing decisions."
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