{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:37:01Z","timestamp":1777419421271,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2008,4,22]],"date-time":"2008-04-22T00:00:00Z","timestamp":1208822400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2008,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Osteoarthritis is prevalent in the elderly. Nova Scotia general practitioners (GPs) identified the need for an academic detailing (AD) intervention aimed at optimizing the management of osteoarthritis. AD was provided by Dalhousie University Continuing Medical Education in a face-to-face encounter employing evidence-based information. GP participation was voluntary.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the effect of a GP-targeted osteoarthritis AD intervention on a reduction in the prescribing of cyclooxygenase-2 (COX-2) inhibitors, as well as examine the intervention effect on the utilization rates of gastroprotective agents and medical services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective cohort study design employing administrative data was used. Differences in utilization rates between intervention and control groups were evaluated using generalized estimating equations analysis for longitudinal data over four 90-day postintervention periods. Confounding was addressed using propensity scores to adjust for between-group bias on the measured covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The between-group difference for change in COX-2 utilization rates was 0.76 defined daily doses\/patient (p = 0.040; 95% CI 0.037 to 1.48) for the 3-month period following the intervention, with lower COX-2 utilization in the AD intervention group than in the control group. The intervention group showed a significant decrease in the within-group utilization rate between the pre- and postintervention periods (z = -2.34; p = 0.019). The between-group difference for change in GP office visit rates was 0.40 visits\/patient (p = 0.028; 95% CI 0.046 to 0.79) with the intervention group, showing higher visit rates compared with the control group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The osteoarthritis AD intervention was associated with a significant decrease (23%) in COX-2 utilization rates in the 3-month period immediately following the intervention. The only secondary outcome to show a significant between-group effect was the GP office visit rate, which was higher for the intervention group in the second 3-month postintervention period.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1k537","type":"journal-article","created":{"date-parts":[[2008,4,22]],"date-time":"2008-04-22T23:19:12Z","timestamp":1208906352000},"page":"749-756","source":"Crossref","is-referenced-by-count":5,"title":["Managed Care: Effect of an Academic Detailing Intervention on the Utilization Rate of Cyclooxygenase-2 Inhibitors in the Elderly"],"prefix":"10.1177","volume":"42","author":[{"given":"Stephen D","family":"Graham","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abraham G","family":"Hartzema","sequence":"additional","affiliation":[{"name":"Perry A Foote Chair in Health Outcomes Research, College of Pharmacy, University of Florida, Gainesville, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid S","family":"Sketris","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Dalhousie University, Canadian Health Services Research Foundation\/Canadian Institutes of Health Research\/Nova Scotia Health Research Foundation Chair in Drug Use Management and Policy Research"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Almut G","family":"Winterstein","sequence":"additional","affiliation":[{"name":"College of Pharmacy, University of Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2008,4,22]]},"reference":[{"key":"bibr1-aph.1K537","author":"Thomson O'brien MA","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr2-aph.1K537","doi-asserted-by":"publisher","DOI":"10.3310\/hta8060"},{"key":"bibr3-aph.1K537","first-page":"380","volume":"200521","author":"Bloom BS","journal-title":"Int J Technol Assess Health Care Summer"},{"key":"bibr4-aph.1K537","unstructured":"Dalhousie University Continuing Medical Education. http:\/\/cme.medicine.dal.ca\/ADS.htm (accessed 2007 Dec 3)."},{"key":"bibr5-aph.1K537","author":"Maclure M","year":"2006","journal-title":"Victoria, BC: Drug Policy Futures"},{"key":"bibr6-aph.1K537","first-page":"54","author":"Bacovsky R","year":"2006","journal-title":"CPJ"},{"key":"bibr7-aph.1K537","unstructured":"Drug Evaluation Alliance of Nova Scotia. www.gov.ns.ca\/health\/Pharmacare\/industry\/deans_academic.asp (accessed 2007 Dec 3)."},{"key":"bibr8-aph.1K537","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-135-8_Part_2-200110161-00010"},{"key":"bibr9-aph.1K537","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199805)41:5<778::AID-ART4>3.0.CO;2-V"},{"key":"bibr10-aph.1K537","unstructured":"Drug and Therapeutics Information Service. www.uky.edu\/UE\/CC\/diabetes.htm (accessed 2007 Dec 3)."},{"key":"bibr11-aph.1K537","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1990.03440040088034"},{"key":"bibr12-aph.1K537","doi-asserted-by":"publisher","DOI":"10.3109\/13814780509178239"},{"key":"bibr13-aph.1K537","unstructured":"AllenM, FerrierS, O'connorN, FlemingI. Family physicians' perceptions of academic detailing: a quantitative and qualitative study. BMC Med Educ 2007;7:36. www.biomedcentral.com\/1472-6920\/7\/36 (accessed 2008 Apr 10)."},{"key":"bibr14-aph.1K537","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.10.1247"},{"key":"bibr15-aph.1K537","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200011233432103"},{"key":"bibr16-aph.1K537","unstructured":"Nova Scotia Department of Health Programs and Services. www.gov.ns.ca\/health\/Pharmacare\/benefitsfaq.asp (accessed 2007 Dec 3)."},{"key":"bibr17-aph.1K537","first-page":"735","volume":"9","author":"Cox ER","year":"2003","journal-title":"Am J Manag Care"},{"key":"bibr18-aph.1K537","unstructured":"Dalhousie University Population Health Research Unit. www.phru.dal.ca (accessed 2007 Dec 3)."},{"key":"bibr19-aph.1K537","unstructured":"Canadian Institute for Health Information. Privacy and confidentiality of health information at CMI: principles and policies for the protection of personal health information and policies for institution-identifiable information. 3rd ed. Ottawa: Canadian Institute for Health Information, 2002."},{"key":"bibr20-aph.1K537","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19981015)17:19<2265::AID-SIM918>3.0.CO;2-B"},{"key":"bibr21-aph.1K537","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/24.1.183"},{"key":"bibr22-aph.1K537","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a010011"},{"key":"bibr23-aph.1K537","author":"Parsons LS","year":"2001","journal-title":"Presented at: 26th Annual SAS Users Group International Conference"},{"key":"bibr24-aph.1K537","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1984.10478078"},{"key":"bibr25-aph.1K537","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-127-8_Part_2-199710151-00064"},{"key":"bibr26-aph.1K537","author":"Shadish WR","year":"2001","journal-title":"Boston: Houghton Mifflin"},{"key":"bibr27-aph.1K537","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2005.07.004"},{"key":"bibr28-aph.1K537","unstructured":"GrahamSD. Effect of academic detailing on utilization rates of COX-2 inhibitors. Gainesville, FL: University of Florida, 2005. http:\/\/purl.fcla.edu\/fcla\/etd\/UFE0011901 (accessed 2008 Apr 11)."},{"key":"bibr29-aph.1K537","unstructured":"World Health Organization Collaborating Center for Drug Statistics Methodology. Guidelines for ATC classification and DDD assignment. Geneva, Switzerland: World Health Organization, 2005."},{"key":"bibr30-aph.1K537","unstructured":"SAS\/STAT Software: release 8.2. Cary, NC: SAS Institute Inc."},{"key":"bibr31-aph.1K537","volume-title":"Safe and effective: the eight essential elements of an optimal medication-use system","author":"Graham SD","year":"2007"},{"key":"bibr32-aph.1K537","doi-asserted-by":"publisher","DOI":"10.1353\/cja.2005.0055"},{"key":"bibr33-aph.1K537","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199303000-00002"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1K537","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1K537","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:10:28Z","timestamp":1777374628000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.1K537"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,4,22]]},"references-count":33,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2008,6]]}},"alternative-id":["10.1345\/aph.1K537"],"URL":"https:\/\/doi.org\/10.1345\/aph.1k537","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,4,22]]}}}