Scientific News | Doctors prescribe fewer painkillers at night than during the day, study finds
Jerusalem [Israel], Jun 28 (ANI): Patient well-being depends on effective pain treatment. According to a recent study, doctors prescribe fewer painkillers at night than during the day.
The research results were published in the journal “Proceedings of the National Academy of Sciences”.
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One of the biggest problems facing the modern healthcare system is pain management. One of the main reasons adults seek medical care is pain, which is thought to have affected nearly 60% of American adults in the past three months.
The research was conducted by a multidisciplinary team led by Professor Shoham Choshen-Hillel of the Hebrew University of Jerusalem (HU) School of Business Administration and the Federmann Center for the Study of Rationality, Dr. Anat Perry of the Department of Psychology at HU and Dr. Alex Gileles. -Hillel of Hadassah Medical Center and HU.
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In the first part of the study, 67 physicians were given empathy assessment tasks in the morning and asked to respond to simulated patient scenarios. These physicians were either at the end of a 26-hour shift or at the start of the workday.
The study found that doctors who recently finished the night shift showed less empathy for patients’ pain. For example, these doctors showed reduced emotional responses to pictures of people in pain and consistently rated their patients at the bottom of pain rating charts.
In the second part of the study, the researchers looked at the actual medical decisions made by emergency room physicians in the United States and Israel. In total, they analyzed 13,482 discharge letters from patients who came to the hospital in 2013-2020 with a main complaint of pain (headache, back pain, etc.).
Across all data sets, physicians were 20-30% less likely to prescribe pain medication during night shifts (compared to day shifts) and prescribed fewer pain medications than generally recommended by the World Organization of health. “They are fatigued and therefore less responsive to patients’ pain. When we looked at ER doctors’ discharge paperwork, we found that they were prescribing less pain medication,” Choshen-Hillel explained.
This bias remained significant even after adjusting for patient-reported level of pain, patient and physician demographics, type of complaint, and emergency department characteristics. “Our conclusion is that night work is an important and previously unrecognized source of bias in pain management, likely due to altered pain perception. The researchers explain that even medical experts, who strive to provide the best care to their patients, are susceptible to the effects of a night shift,” noted Perry.
For the future, the researchers suggest implementing more structured pain management guidelines in hospitals. Another important implication relates to the work structure of physicians and the need to improve physician work schedules. “Our findings may have implications for other workplaces that involve shift work and empathetic decision-making, including crisis centers, first responders, and the military. In fact, these findings should probably apply to all people who are sleep deprived,” added Gileles-Hillel. (ANI)
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