Randomized trial of two physiotherapy interventions for primary care back and neck pain patients: Cost-effectiveness analysis

Andrea Manca, J. C. Dumville, D. J. Torgerson, J. A. Klaber Moffett, M. P. Mooney, D. A. Jackson, S. Eaton

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Objectives. To assess the cost-effectiveness of a brief physiotherapy pain management approach using cognitive-behavioural principles (Solution-Finding Approach) when compared with a commonly used traditional method of physical therapy (McKenzie Approach). Methods. Economic evaluation conducted alongside a randomized trial. The study related incremental differences in costs and benefits associated with the Solution Finding and McKenzie approaches over 12 months. Costs were measured in UK pounds sterling. Benefit was measured as health-related quality of life using the EQ-5D, which was used to estimate patient-specific quality adjusted life years (QALYs). Results. The McKenzie treatment required, on average, one extra physiotherapist visit (4.15 vs 3.10). Over a 12-month period, Solution Finding was associated with a lower per patient cost of £-24.4 (95% CI £-49.6 to £0.789). The mean difference in QALYs between the two groups was -0.020 (95% CI -0.057 to 0.017); favouring those receiving McKenzie. Relating incremental mean costs and QALYs gave an incremental cost effectiveness ratio of £1220 (-24.4/-0.020) suggesting the McKenzie treatment is cost effective. Conclusions. Results suggest that the additional cost associated with the McKenzie treatment when compared with the Solution Finding Approach may be worth paying, given the additional benefit the approach seems more likely to provide. Further research is needed to assess the extent to which the difference in physiotherapy visits between the two strategies is generalizable to other treatment settings. © The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
    Original languageEnglish
    Pages (from-to)1495-1501
    Number of pages6
    JournalRheumatology
    Volume46
    Issue number9
    DOIs
    Publication statusPublished - Sept 2007

    Keywords

    • Benefits
    • Cost
    • Neck and back pain
    • Physiotherapy
    • Primary care

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