Shorter Primary Care Visit Length Linked to Inappropriate Prescribing

FRIDAY, March 10, 2023 (HealthDay News) — For patients with primary care visits, shorter visit length is associated with potentially inappropriate prescribing decisions, according to a study published online March 10 in JAMA Health Forum.

Hannah T. Neprash, Ph.D., from the University of Minnesota in Minneapolis, and colleagues examined variations in primary care visit length and quantified the association between visit length and potentially inappropriate prescribing decisions by primary care physicians using data from electronic health record systems in primary care offices throughout the United States. Data were included for 8,119,161 primary care visits by 4,360,445 patients with 8,091 primary care physicians.

The researchers found that longer visits were more complex, with more diagnoses recorded and/or more chronic conditions coded. Younger, publicly insured, Hispanic, and non-Hispanic Black patients had shorter visits after controlling for scheduled visit duration and measures of visit complexity. The likelihood that a visit resulted in inappropriate antibiotic prescription for upper respiratory tract infections changed by −0.11 percentage points, and the likelihood of opioid and benzodiazepine coprescribing changed by −0.01 percentage points for each additional minute of visit length. Among older adults, visit length was positively associated with potentially inappropriate prescribing (0.004 percentage points).

“Shorter visit length was associated with higher rates of inappropriate antibiotic prescribing for upper respiratory tract infections and inappropriate coprescribing of opioids and benzodiazepines for patients with painful conditions, but similar patterns were not found for other potentially inappropriate prescribing decisions,” the authors write.

One author disclosed ties to F-Prime and Arnold Ventures.