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Cost-effectiveness of two self-care interventions to reduce disability associated with back pain.
Spine (Phila Pa 1976). 2006 Jul 01; 31(15):1639-45.S

Abstract

STUDY DESIGN

Two randomized, controlled trials.

OBJECTIVE

To evaluate the incremental cost-effectiveness of psychologist-led and lay-led interventions in reducing disability in 2 cohorts of primary care patients with back pain.

SUMMARY OF BACKGROUND DATA

Although activating self-care interventions have been advanced as effective tools to reduce back pain-related activity limitations, few studies have evaluated the added costs of these programs relative to their added benefits.

METHODS

We estimated the incremental benefits and incremental costs associated with 2 self-care interventions for primary care patients with back pain. Effectiveness was measured as the number of low-impact back pain days (i.e., days when patients were satisfied with their level of back pain) over a 1-year follow-up. Costs of back-pain related services were estimated from health plan cost data. Incremental cost-effectiveness ratios were calculated for each intervention to determine the costs associated with an additional low-impact back pain day.

RESULTS

Patients assigned to the lay and psychologist interventions had a mean of 14.3 (95% confidence interval [CI] -2.7 to 30.9) and 26.2 (95% CI 9.1-44.4) additional low-impact back pain days, respectively, compared with patients receiving usual care. The incremental per-person costs of the lay-led and psychologist-led interventions were dollar 139 (95% CI - dollar 62.13 to dollar 321.76) and dollar 161 (95% CI dollar 51.18 to dollar 275.93), respectively. The mean cost of an additional low-impact back pain day was dollar 9.70 for the lay-led intervention and dollar 6.13 for the psychologist-led intervention.

CONCLUSIONS

Both the lay and psychologist interventions were associated with modest improvements in outcomes but with somewhat higher costs compared to usual care.

Authors+Show Affiliations

Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA. Lstrong@u.washington.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

16816756

Citation

Strong, Larkin L., et al. "Cost-effectiveness of Two Self-care Interventions to Reduce Disability Associated With Back Pain." Spine, vol. 31, no. 15, 2006, pp. 1639-45.
Strong LL, Von Korff M, Saunders K, et al. Cost-effectiveness of two self-care interventions to reduce disability associated with back pain. Spine (Phila Pa 1976). 2006;31(15):1639-45.
Strong, L. L., Von Korff, M., Saunders, K., & Moore, J. E. (2006). Cost-effectiveness of two self-care interventions to reduce disability associated with back pain. Spine, 31(15), 1639-45.
Strong LL, et al. Cost-effectiveness of Two Self-care Interventions to Reduce Disability Associated With Back Pain. Spine (Phila Pa 1976). 2006 Jul 1;31(15):1639-45. PubMed PMID: 16816756.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of two self-care interventions to reduce disability associated with back pain. AU - Strong,Larkin L, AU - Von Korff,Michael, AU - Saunders,Kathleen, AU - Moore,James E, PY - 2006/7/4/pubmed PY - 2006/8/5/medline PY - 2006/7/4/entrez SP - 1639 EP - 45 JF - Spine JO - Spine (Phila Pa 1976) VL - 31 IS - 15 N2 - STUDY DESIGN: Two randomized, controlled trials. OBJECTIVE: To evaluate the incremental cost-effectiveness of psychologist-led and lay-led interventions in reducing disability in 2 cohorts of primary care patients with back pain. SUMMARY OF BACKGROUND DATA: Although activating self-care interventions have been advanced as effective tools to reduce back pain-related activity limitations, few studies have evaluated the added costs of these programs relative to their added benefits. METHODS: We estimated the incremental benefits and incremental costs associated with 2 self-care interventions for primary care patients with back pain. Effectiveness was measured as the number of low-impact back pain days (i.e., days when patients were satisfied with their level of back pain) over a 1-year follow-up. Costs of back-pain related services were estimated from health plan cost data. Incremental cost-effectiveness ratios were calculated for each intervention to determine the costs associated with an additional low-impact back pain day. RESULTS: Patients assigned to the lay and psychologist interventions had a mean of 14.3 (95% confidence interval [CI] -2.7 to 30.9) and 26.2 (95% CI 9.1-44.4) additional low-impact back pain days, respectively, compared with patients receiving usual care. The incremental per-person costs of the lay-led and psychologist-led interventions were dollar 139 (95% CI - dollar 62.13 to dollar 321.76) and dollar 161 (95% CI dollar 51.18 to dollar 275.93), respectively. The mean cost of an additional low-impact back pain day was dollar 9.70 for the lay-led intervention and dollar 6.13 for the psychologist-led intervention. CONCLUSIONS: Both the lay and psychologist interventions were associated with modest improvements in outcomes but with somewhat higher costs compared to usual care. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/16816756/Cost_effectiveness_of_two_self_care_interventions_to_reduce_disability_associated_with_back_pain_ L2 - https://doi.org/10.1097/01.brs.0000224528.75951.03 DB - PRIME DP - Unbound Medicine ER -