Clinicians may be less likely to prescribe statin therapy to patients during afternoon appointments than they are during morning appointments, according to a research letter published Feb. 1 the Journal of the American College of Cardiology.

Allison H. Oakes, PhD, et al., sought to explore whether appointment time is associated with statin prescribing by cardiologists. The authors examined data on cardiologist appointments from 15 practice sites in the University of Pennsylvania Health System between March 2018 and Sept. 2019.

Data from 10,353 visits for 7,271 statin-naïve patients were included in the study. The authors noted that clinical characteristics of patients included in the study were similar across the morning and afternoon appointment times.

Results showed that the statin order rate was 5.4% during morning visits and 4.4% during afternoon visits. New statin prescription significantly declined as the clinic day progressed, with the largest reduction occurring between 12 p.m. and 2 p.m.

The authors attribute the reduction in prescription rate to both patients and clinicians being susceptible to decision fatigue, and clinicians running behind schedule as the day progresses.

"This finding expands our understanding of how time of day broadly influences health care quality across practice environments," write the authors. "Addressing this problem will require the development and implementation of behavioral interventions that precisely target the cognitive constraints, biases, and social motivations of clinicians and patients."

Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Prevention, Sports and Exercise Cardiology, Exercise

Keywords: Motivation, Appointments and Schedules, Cardiology, Quality of Health Care, Prescriptions, Running, Fatigue, Cognition

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