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
Objective: To 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).
Design: Cost-utility and cost-effectiveness analyses alongside a multicentre controlled trial from a healthcare perspective with a 1-year time horizon.
Setting: The trial was conducted in eight centres within the Sharon district in Israel.
Participants: 220 participants aged between 25 and 55 years who suffered from CLBP for a minimum of 3 months were recruited.
Interventions: The 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 measures: The 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.
Results: The 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.
Conclusions: The 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.
Canway, Alastair
809a67e0-ffe7-4b2e-84db-a2bc1173c090
Pincus, Tamar
55388347-5d71-4fc0-9fd2-66fbba080e0c
Underwood, Martin
239a8609-e7b5-4acb-aaf9-9e7f717f0d62
Shapiro, Yair
bf5f3d17-985c-4af3-b1f7-62be9c38c35d
Chodick, Gabriel
ae5cab8d-476b-4d42-a53a-242c0fadeecf
Ben Ami, Noa
99af5f24-d185-4fd7-8059-fee3baf7690d
10 April 2018
Canway, Alastair
809a67e0-ffe7-4b2e-84db-a2bc1173c090
Pincus, Tamar
55388347-5d71-4fc0-9fd2-66fbba080e0c
Underwood, Martin
239a8609-e7b5-4acb-aaf9-9e7f717f0d62
Shapiro, Yair
bf5f3d17-985c-4af3-b1f7-62be9c38c35d
Chodick, Gabriel
ae5cab8d-476b-4d42-a53a-242c0fadeecf
Ben Ami, Noa
99af5f24-d185-4fd7-8059-fee3baf7690d
Canway, Alastair, Pincus, Tamar, Underwood, Martin, Shapiro, Yair, Chodick, Gabriel and Ben Ami, Noa
(2018)
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.
BMJ Open, 8 (4), [e019928].
(doi:10.1136/bmjopen-2017-019928).
Abstract
Objective: To 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).
Design: Cost-utility and cost-effectiveness analyses alongside a multicentre controlled trial from a healthcare perspective with a 1-year time horizon.
Setting: The trial was conducted in eight centres within the Sharon district in Israel.
Participants: 220 participants aged between 25 and 55 years who suffered from CLBP for a minimum of 3 months were recruited.
Interventions: The 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 measures: The 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.
Results: The 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.
Conclusions: The 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.
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More information
Accepted/In Press date: 10 April 2018
Published date: 10 April 2018
Additional Information:
M1 - e019928
Identifiers
Local EPrints ID: 469288
URI: http://eprints.soton.ac.uk/id/eprint/469288
ISSN: 2044-6055
PURE UUID: c707ee68-c485-448c-8e0c-29a1ff0d1108
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Date deposited: 12 Sep 2022 17:19
Last modified: 17 Mar 2024 04:11
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Contributors
Author:
Alastair Canway
Author:
Tamar Pincus
Author:
Martin Underwood
Author:
Yair Shapiro
Author:
Gabriel Chodick
Author:
Noa Ben Ami
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