The implementation of academic detailing and its effectiveness on appropriate prescribing of pain relief medication: a real-world cluster randomized trial in Belgian general practices

Table 4 Covariates’ effect on the impact of the intervention on primary outcomes in an intention to treat analysis

	PO1: odds ratio [95% Wald CI]	PO2: estimate [95% Wald CI]	PO3: odds ratio [95% Wald CI]	PO4: odds ratio [95% Wald CI]
Region (Flanders)
Step change	1.0191 [0.9937; 1.0452]	1.3193** [0.4784; 2.1603]	0.979 [0.8346; 1.1483]	1.0559 [0.8941; 1.2470]
Change in trend	0.9970 [0.9791; 1.0153]	− 0.0647 [− 0.4576; 0.3283]	0.9932 [0.9540; 1.0340]	0.9987 [0.9554; 10,439]
Number of general practitioners visited by Farmaka before in the practice
Step change	1.0062 [0.9893; 1.0235]	0.6101** [0.1596; 1.0606]	0.9726 [0.9364; 1.0102]	0.9977 [0.9213; 1.0805]
Change in trend	0.9922 [0.9843; 1.0001]	− 0.0514 [− 0.1801; 0.0774]	0.9944 [0.9826; 1.0064]	0.9925 [0.9749; 1.0105]
Number of previously received visits
Step change	1.0002 [0.9977; 1.0027]	− 0.0639 [− 0.2455; 0.1177]	1.0095* [1.0019; 1.0172]	1.0056 [0.9887; 1.0229]
Change in trend	1.0010 [0.9998; 1.0022]	0.0243 [− 0.0166; 0.0653]	0.9993 [0.9972; 1.0014]	0.9978 [0.9953; 1.0004]
Age of academic detailer ≥ 40 years)
Step change	0.9741 [0.9482; 1.0007]	− 0.8419** [− 1.3166; − 0.3673]	1.0570 [0.9736; 1.1475]	0.9391 [0.8559; 1.0305]
Change in trend	1.0067 [0.9901; 1.0235]	0.2232 [− 0.1231; 0.5696]	0.9922 [0.9691; 1.0159]	1.0087 [0.9930; 1.0247]
Academic detailer physician
Step change	0.9698 [0.9337; 1.0072]	− 0.7183 [− 1.6650; 0.2284]	1.0786* [1.0038; 1.159]	0.9706 [0.8948; 1.0528]
Change in trend	1.0040 [0.9843; 1.0242]	0.2245 [− 0.0665; 0.5155]	1.0075 [0.9923; 1.0229]	1.0267** [1.0075; 1.0463]

Step change difference in step change between the intervention and control group immediately after the intervention; change in trend difference between the change in trend between the intervention and control group after the intervention; PO1 proportion of patients reimbursed for an analgesic; PO2 average defined daily dose of paracetamol per patient reimbursed for paracetamol per month; PO3 proportion of patients reimbursed for a recommended nonsteroidal anti-inflammatory drug (NSAID) among those reimbursed for any NSAID; PO4 proportion of patients reimbursed for an NSAID and a proton-pump inhibitor among those reimbursed for an NSAID; *p value < 0.05; **p value < 0.01; underlined < 0.05 in all four analyses (ITT, ITT-V1, ITT-V2 and PPR)

ISSN: 1748-5908