HealthDay News — Statin prescribing for at-risk individuals decreases among primary care providers as the day progresses, particularly in the afternoon compared with the morning, according to a research letter published online May 11 in JAMA Network Open.
Allison J. Hare, from University of Pennsylvania in Philadelphia, and colleagues evaluated the association between primary care appointment times and statin prescribing rates for patients with an elevated risk for major adverse cardiovascular events (e.g., presence of clinical atherosclerotic cardiovascular disease or familial hypercholesterolemia diagnosis, or low-density lipoprotein cholesterol ≥190 mg/dL). The analysis included data from 28 Penn Medicine primary care practices (10,757 patients; March 1, 2019, to February 29, 2020).
The researchers found that overall, statins were prescribed in 35.9 percent of visits (37.5 percent for morning visits and 33.4 percent during afternoon visits). The odds of statin prescribing during afternoon appointments were significantly lower (adjusted odds ratio, 0.79; 95 percent confidence interval [CI], 0.73 to 0.87; P < 0.001) compared with morning appointments. The odds of statin prescribing were significantly lower for all hours compared with 8 a.m., except for 9 a.m. (adjusted odds ratios, 0.88 [95 percent CI, 0.76 to 1.02; P = 0.10]; 0.85 [95 percent CI, 0.73 to 0.99; P = 0.04]; 0.63 [95 percent CI, 0.49 to 0.83; P = 0.001]; and 0.69 [95 percent CI, 0.57 to 0.82; P < 0.001] for 9 a.m., 10 a.m., 12 p.m., and 3 p.m., respectively).
“As the day progresses, clinicians may run behind schedule which can lead to rushed interactions, decreased bandwidth for discussions of indicated therapies, or implicit agreements to defer complex decisions,” the authors write.
One author disclosed financial ties to the health information and technology industries.