A Cost Utility Analysis of Interdisciplinary Early Intervention Versus Treatment as Usual For High-Risk Acute Low Back Pain Patients

Abstract

Chronic pain is a costly and debilitating condition that has proven difficult to treat, solely with medical interventions, due to the complex interplay of biological, psychological, and social factors in its onset and persistence. Many studies have demonstrated the effectiveness of interdisciplinary treatment that includes psychosocial interventions for low back pain. Nevertheless, these interventions continue to be under-utilized due to concerns of cost and applicability. The present study utilized a cost utility analysis to evaluate effectiveness and associated costs of interdisciplinary early intervention for individuals with acute low back pain that was identified as high-risk for becoming chronic. Treatment effectiveness was evaluated using a standard pain measure and quality-adjusted life years, and associated medical and employment costs were gathered for 1 year. Results indicated that subjects improved significantly from pretreatment to 1-year follow-up, and that the early intervention group reported fewer health-care visits and missed workdays than the treatment as usual group. The majority of 1,000 bootstrapped samples demonstrated the dominance of the early intervention program as being both more effective and less costly from a societal perspective. The early intervention treatment was the preferred option in over 85% of samples within an established range of acceptable costs. These results are encouraging evidence for the cost-effectiveness of interdisciplinary intervention and the benefits of targeted early treatment.

Effectiveness evaluation of an integrated automatic termomechanic massage system (SMATH® system) in non-specific sub-acute and chronic low back pain - a randomized double-blinded controlled trial, comparing SMATH therapy versus sham therapy: study protocol for a randomized controlled trial

“…Sequence generation has been achieved through a "congruential multiplier" statistical algorithm application, using IBM Statistical Package for Social Sciences (SPSS) Version 19 [21,22] and was stratified with 1:1 allocation random block size of 36. The randomization list reports a progressive randomization number for randomized participants (from 1 to 72), and the treatment (A or B) will be assigned for each of them.…”

Benefits of Using an Early Palliative Care Intervention in Pediatric Oncology

“…7 Cost analyses of health care interventions are essential in today's ever-changing health care field to ensure quality care while health care costs continue to increase annually. 8,9 Therefore, the authors of this article propose that home delivery of chemotherapy is an example of a PC intervention that can improve the QOL of pediatric oncology patients, foster a cost savings plan, and also support the WHO definition of PC.…”

“…Also, in several studies, investigators have reported that a major benefit of outpatient delivery of chemotherapy results in significant reduced health care costs (ie, due to decreased hospital admissions). 8,9,[11][12][13] Standard risk medulloblastoma (SRMB) patients spend approximately 14 months after diagnosis undergoing radiation and chemotherapy. Because survival has improved to almost 90%, 14 it is imperative to focus not only on the QOL of survivors but also on the patient's QOL while receiving oncology treatments.…”

The Chronic Low Back Pain Epidemic in Older Adults in America

“…This interdisciplinary approach is aimed at tailoring treatment to individual-patient needs in order to promote maximum rehabilitation in both physical and psychosocial areas, using a combination of cognitive behavioral therapy (CBT), physical conditioning, and psychosocial evaluations that are carefully monitored by a team of health-care professionals [18][19][20]. This approach has been shown to be highly effective, both therapeutically and in terms of cost effectiveness [21][22][23]. Other forms of physical modalities for pain management that have been studied and displayed to have some promising results in aiding pain relief include myofascial-release therapy, chiropractic care, and exercise to improve coordination/stabilization, strength/resistance, and cardiovascular training groups [24][25][26].…”