Generic Preference-based Measures for Low Back Pain

Finch, Aureliano Paolo; Dritsaki, Melina; Jommi, Claudio

doi:10.1097/brs.0000000000001247

Cited by 20 publications

(21 citation statements)

References 61 publications

(179 reference statements)

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“… 17 A limitation of this is that the study was conducted in Israel and no Israel-specific tariff exists, and preferences for health states may differ from those where the tariff originates. Furthermore, although the SF-12 is validated and reliable for patients with lower back pain, 34 the evidence surrounding the SF-6D is more limited 35 and future studies should explore the use of other utility measures. CLBP by definition is a chronic condition; the 1-year follow-up is therefore a limitation as the long-term effectiveness and adherence could not be thoroughly assessed.…”

Section: Discussionmentioning

confidence: 99%

Is an enhanced behaviour change intervention cost-effective compared with physiotherapy for patients with chronic low back pain? Results from a multicentre trial in Israel

et al. 2018

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ObjectiveTo assess the cost-effectiveness of an enhanced transtheoretical model of behaviour change in conjunction with physiotherapy compared with standard care (physiotherapy) in patients with chronic lower back pain (CLBP).DesignCost-utility and cost-effectiveness analyses alongside a multicentre controlled trial from a healthcare perspective with a 1-year time horizon.SettingThe trial was conducted in eight centres within the Sharon district in Israel.Participants220 participants aged between 25 and 55 years who suffered from CLBP for a minimum of 3 months were recruited.InterventionsThe intervention used a model of behaviour change that sought to increase the adherence and implementation of physical activity in conjunction with physiotherapy. The control arm received standard care in the form of physiotherapy.Primary and secondary measuresThe primary outcome was the incremental cost per quality-adjusted life year (QALY) of the intervention arm compared with standard care. The secondary outcome was the incremental cost per Roland-Morris Disability Questionnaire point.ResultsThe cost per QALY point estimate was 10 645 New Israeli shekels (NIS) (£1737.11). There was an 88% chance the intervention was cost-effective at NIS50 000 per QALY threshold. Excluding training costs, the intervention dominated the control arm, resulting in fewer physiotherapy and physician visits while improving outcomes.ConclusionsThe enhanced transtheoretical model intervention appears to be a very cost-effective intervention leading to improved outcomes for low cost. Given limitations within this study, there is justification for examining the intervention within a larger, long-term randomised controlled trial.Trial registration numberNCT01631344; Pre-results.

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Section: Discussionmentioning

confidence: 99%

Is an enhanced behaviour change intervention cost-effective compared with physiotherapy for patients with chronic low back pain? Results from a multicentre trial in Israel

et al. 2018

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“…The EQ-5D and SF-6D have been used and validated in different LBP populations. [13][14][15][16] To date, it is recommended to use several instruments to measure HRQoL 10 but not always done, especially in clinical studies. It is also worthwhile to note that the EQ-5D is available in two versions: EuroQol Five Dimensions Three Levels (EQ-5D-3L) and EuroQol Five Dimensions Five Levels (EQ-5D-5L).…”

Section: Introductionmentioning

confidence: 99%

<p>Predicting EQ-5D-5L Utility Scores from the Oswestry Disability Index and Roland-Morris Disability Questionnaire for Low Back Pain</p>

Poder¹,

Carrier²

2020

JPR

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Background: Cost utility analysis is important for measuring the impact of chronic disease and helps clinicians and policymakers in patient management and policy decisions, but generic preference-based measures are not always considered in clinical studies. Objective: To evaluate if health-related quality-of-life (HRQoL)-specific questionnaires used in chronic low back pain (CLBP) can predict EQ-5D-5L utility scores. Methods: The data come from an online survey on low back pain conducted between October 2018 and January 2019. Health utility scores for EuroQol Five Dimensions Five Levels (EQ-5D-5L) were calculated with the recommended model of Xie et al. The EQ-5D-5L health states ranged from −0.148 for the worst (55555) to 0.949 for the best (11111). Univariate and multivariate linear regression were performed to predict EQ-5D-5L with Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ) and clinical variables. Results: Analyses were performed in 408 subjects who completed the questionnaires EQ-5D-5L, ODI or RMDQ. Median (range) of EQ-5D-5L was 0.622 (−0.072 to 0.905). There was high correlation between EQ-5D-5L and ODI (r=−0.78, p<0.001), while it was moderate with RMDQ (r=−0.62, p<0.001). The multivariate model to predict EQ-5D-5L with ODI explained 67.6% of variability, and the correlation between actual and predicted EQ-5D-5L was 0.82. Principal predictors were ODI, duration of LBP, invalidity, health satisfaction (0-10 cm), life satisfaction (0-10 cm), and intensity of pain today (0-10 cm). Conclusion: Data from this study demonstrated that individual correlation between ODI and EQ-5D-5L was high, but moderate with RMDQ. Correlations between actual and predicted EQ-5D-5L from multivariate models were higher and very high. Considering these results, the multivariate model can be used in similar studies for patient with CLBP to estimate the utility scores from the ODI when the EQ-5D-5L was not measured.

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“…It is practical, reliable, valid, and responsive in patients with chronic diseases, 26 , 27 including CP. 28 , 29 Compared to the EQ-5D-3L, it shows improved measurement properties, a reduced ceiling effect, and improved discriminatory power. 30 In patients with persistent oro-facial pain, the EQ-5D-5L has been demonstrated to have sufficient convergent validity.…”

Section: Discussionmentioning

confidence: 99%

Improved health-related quality of life, participation, and autonomy in patients with treatment-resistant chronic pain after an intensive social cognitive intervention with the participation of support partners

Jongen¹,

Ruimschotel²,

Museler-Kreijns³

et al. 2017

JPR

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Despite the availability of various specific treatments, most patients with chronic pain (CP) consider their pain problem as undertreated. Recently, multiple sclerosis (MS) patients who were given an intensive 3-day social cognitive treatment with the participation of support partners experienced lasting improvements in health-related quality of life (HRQoL) and self-efficacy. In this study, a similar intervention was given to treatment-resistant CP patients with stressors, relational problems with support partner, and distress, anxiety or depression. Before and 1, 3, and 6 months after the intervention, patients completed the Euro-Qol 5 Dimensions 5 Levels (EQ-5D-5L) and Impact on Participation and Autonomy (IPA) questionnaires (primary outcomes), and the Survey Of Pain Attitudes (SOPA), the Four-Dimensional Symptom Questionnaire (4DSQ) (distress, depression, anxiety, and somatization), and Visual Analog Scale for pain intensity, whereas the support partners completed the Caregiver Strain Index (CSI) questionnaire. Differences between baseline and post-treatment were tested via paired t-tests (significance level 0.05). Of the 39 patients who were included, 34 (87.2%) completed the 3-day treatment. At 1, 3, and 6 months, improvements were seen in EQ-5D-5L-Index (+40.6%; +22.4%; +31.7%), Health Today (+61.8%; +36.3%; +46.8%), Control attitude (+45.8%; not significant [NS]; +55.0%) and decreases in IPA-Problems (−14.8%; NS; −20.4%), Harm attitude (−18.9%; −15.0%; −17.7%), Distress (−17.7%; −31.8%; −37.1%), and Depression (−37.4%; −31.4%; −35.7%) scores. The CSI score had decreased by −29.0%, −21.4%, and −25.9%, respectively. In conclusion, after an intensive 3-day social cognitive intervention, treatment-resistant CP patients experienced substantial and lasting improvements in HRQoL and in problematic limitations to participation and autonomy, in association with improvements in pain attitudes, depression, and distress. To assess whether this innovative approach may be an effective treatment for this subgroup of CP patients, future randomized controlled studies are needed.

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Generic Preference-based Measures for Low Back Pain

Cited by 20 publications

References 61 publications

Is an enhanced behaviour change intervention cost-effective compared with physiotherapy for patients with chronic low back pain? Results from a multicentre trial in Israel

Is an enhanced behaviour change intervention cost-effective compared with physiotherapy for patients with chronic low back pain? Results from a multicentre trial in Israel

<p>Predicting EQ-5D-5L Utility Scores from the Oswestry Disability Index and Roland-Morris Disability Questionnaire for Low Back Pain</p>

Improved health-related quality of life, participation, and autonomy in patients with treatment-resistant chronic pain after an intensive social cognitive intervention with the participation of support partners

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