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Cost-effectiveness of using a motion-sensor biofeedback treatment approach for the management of sub-acute or chronic low back pain: economic evaluation alongside a randomised trial.
BMC Musculoskelet Disord. 2017 01 17; 18(1):18.BM

Abstract

BACKGROUND

Low back pain is a common and costly condition internationally. There is high need to identify effective and economically efficient means for managing this problem. This study aimed to explore the cost-effectiveness of a novel motion-sensor biofeedback treatment approach in addition to guidelines-based care compared to guidelines-based care alone, from a societal perspective over a 12 month time horizon.

METHOD

This was an incremental cost-effectiveness analysis conducted concurrently with a pilot, cluster randomized controlled trial. Health care resource use was collected using daily diaries and patient-self report at 3, 6 and 12 month follow-up assessments. Productivity was measured using industry classifications and participant self-reporting of ability to do their normal work with their present pain. Clinical effect was measured using the Patient Global Impression of Change measured at the 12 month follow-up assessment. Data were compared between groups using linear regression clustered by recruitment site. Bootstrap resampling was used to generate a visual representation of the 95% confidence interval for the incremental cost-effectiveness estimate. Two, one-way sensitivity analyses were undertaken to examine the robustness of findings to key assumptions.

RESULT

There were n = 38 participants in the intervention group who completed the 12 month assessment and n = 45 in the control. The intervention group had greater use of trial-related medical and therapy resources [$477 per participant (95% CI: $447, $508)], but lower use of non-trial medical and therapy resources [$-53 per participant (95% CI: $-105, $-0)], and a greater improvement in productivity [$-5123 per participant (95% CI: $-10,174, $-72)]. Overall, the intervention dominated with a saving of $478,100 and an additional 41 participants self-rating as being very or much improved compared to the control. There was >99% confidence in this finding of dominance in both the primary and sensitivity analyses.

CONCLUSIONS

The motion-sensor biofeedback treatment approach in addition to guidelines- based care appears to be both more clinically effective and economically efficient than guidelines- based care alone. This approach appears to be a viable means to manage low back pain and further research in this area should be a priority.

TRIAL REGISTRATION

The randomised trial this research was based upon was prospectively registered on March 25th 2009 with the Australian New Zealand Clinical Trials Registry: ACTRN12609000157279 .

Authors+Show Affiliations

Allied Health Research Unit & Physiotherapy Department, School of Primary Health Care, Monash University and Monash Health, Kingston Rd, Cheltenham, 3192, Australia. Terrence.haines@monash.edu.Allied Health Research Unit & Physiotherapy Department, School of Primary Health Care, Monash University and Monash Health, Kingston Rd, Cheltenham, 3192, Australia.

Pub Type(s)

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

Language

eng

PubMed ID

28095832

Citation

Haines, Terry, and Kelly-Ann Bowles. "Cost-effectiveness of Using a Motion-sensor Biofeedback Treatment Approach for the Management of Sub-acute or Chronic Low Back Pain: Economic Evaluation Alongside a Randomised Trial." BMC Musculoskeletal Disorders, vol. 18, no. 1, 2017, p. 18.
Haines T, Bowles KA. Cost-effectiveness of using a motion-sensor biofeedback treatment approach for the management of sub-acute or chronic low back pain: economic evaluation alongside a randomised trial. BMC Musculoskelet Disord. 2017;18(1):18.
Haines, T., & Bowles, K. A. (2017). Cost-effectiveness of using a motion-sensor biofeedback treatment approach for the management of sub-acute or chronic low back pain: economic evaluation alongside a randomised trial. BMC Musculoskeletal Disorders, 18(1), 18. https://doi.org/10.1186/s12891-016-1371-6
Haines T, Bowles KA. Cost-effectiveness of Using a Motion-sensor Biofeedback Treatment Approach for the Management of Sub-acute or Chronic Low Back Pain: Economic Evaluation Alongside a Randomised Trial. BMC Musculoskelet Disord. 2017 01 17;18(1):18. PubMed PMID: 28095832.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of using a motion-sensor biofeedback treatment approach for the management of sub-acute or chronic low back pain: economic evaluation alongside a randomised trial. AU - Haines,Terry, AU - Bowles,Kelly-Ann, Y1 - 2017/01/17/ PY - 2016/06/10/received PY - 2016/12/19/accepted PY - 2017/1/19/entrez PY - 2017/1/18/pubmed PY - 2017/9/28/medline KW - Cost-effectiveness KW - Economic evaluation KW - Low back pain KW - Randomized trial SP - 18 EP - 18 JF - BMC musculoskeletal disorders JO - BMC Musculoskelet Disord VL - 18 IS - 1 N2 - BACKGROUND: Low back pain is a common and costly condition internationally. There is high need to identify effective and economically efficient means for managing this problem. This study aimed to explore the cost-effectiveness of a novel motion-sensor biofeedback treatment approach in addition to guidelines-based care compared to guidelines-based care alone, from a societal perspective over a 12 month time horizon. METHOD: This was an incremental cost-effectiveness analysis conducted concurrently with a pilot, cluster randomized controlled trial. Health care resource use was collected using daily diaries and patient-self report at 3, 6 and 12 month follow-up assessments. Productivity was measured using industry classifications and participant self-reporting of ability to do their normal work with their present pain. Clinical effect was measured using the Patient Global Impression of Change measured at the 12 month follow-up assessment. Data were compared between groups using linear regression clustered by recruitment site. Bootstrap resampling was used to generate a visual representation of the 95% confidence interval for the incremental cost-effectiveness estimate. Two, one-way sensitivity analyses were undertaken to examine the robustness of findings to key assumptions. RESULT: There were n = 38 participants in the intervention group who completed the 12 month assessment and n = 45 in the control. The intervention group had greater use of trial-related medical and therapy resources [$477 per participant (95% CI: $447, $508)], but lower use of non-trial medical and therapy resources [$-53 per participant (95% CI: $-105, $-0)], and a greater improvement in productivity [$-5123 per participant (95% CI: $-10,174, $-72)]. Overall, the intervention dominated with a saving of $478,100 and an additional 41 participants self-rating as being very or much improved compared to the control. There was >99% confidence in this finding of dominance in both the primary and sensitivity analyses. CONCLUSIONS: The motion-sensor biofeedback treatment approach in addition to guidelines- based care appears to be both more clinically effective and economically efficient than guidelines- based care alone. This approach appears to be a viable means to manage low back pain and further research in this area should be a priority. TRIAL REGISTRATION: The randomised trial this research was based upon was prospectively registered on March 25th 2009 with the Australian New Zealand Clinical Trials Registry: ACTRN12609000157279 . SN - 1471-2474 UR - https://www.unboundmedicine.com/medline/citation/28095832/Cost_effectiveness_of_using_a_motion_sensor_biofeedback_treatment_approach_for_the_management_of_sub_acute_or_chronic_low_back_pain:_economic_evaluation_alongside_a_randomised_trial_ L2 - https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-016-1371-6 DB - PRIME DP - Unbound Medicine ER -