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BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Cost-effectiveness of providing patients with information on managing mild low-back symptoms in an occupational health setting

Authors: J. Rantonen, J. Karppinen, A. Vehtari, S. Luoto, E. Viikari-Juntura, M. Hupli, A. Malmivaara, S. Taimela

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

Evidence shows that low back specific patient information is effective in sub-acute low back pain (LBP), but effectiveness and cost-effectiveness (CE) of information in early phase symptoms is not clear. We assessed effectiveness and CE of patient information in mild LBP in the occupational health (OH) setting in a quasi-experimental study.

Methods

A cohort of employees (N = 312, aged <57) with non-specific, mild LBP (Visual Analogue Scale between 10–34 mm) was selected from the respondents of an employee survey (N = 2480; response rate 71 %). A random sample, representing the natural course of LBP (NC, N = 83; no intervention), was extracted as a control group. Remaining employees were invited (181 included, 47 declined, one excluded) into a randomised controlled study with two 1:1 allocated parallel intervention arms (“Booklet”, N = 92; “Combined”, N = 89). All participants received the “Back Book” patient information booklet and the Combined also an individual verbal review of the booklet. Physical impairment (PHI), LBP, health care (HC) utilisation, and all-cause sickness absence (SA) were assessed at two years. CE of the interventions on SA days was analysed by using direct HC costs in one year, two years from baseline. Multiple imputation was used for missing values.

Results

Compared to NC, the Booklet reduced HC costs by 196€ and SA by 3.5 days per year. In 81 % of the bootstrapped cases the Booklet was both cost saving and effective on SA. Compared to NC, in the Combined arm, the figures were 107€, 0.4 days, and 54 %, respectively. PHI decreased in both interventions.

Conclusions

Booklet information alone was cost-effective in comparison to natural course of mild LBP. Combined information reduced HC costs. Both interventions reduced physical impairment. Mere booklet information is beneficial for employees who report mild LBP in the OH setting, and is also cost saving for the health care system.

Trial registration

ClinicalTrials.gov NCT00908102
Appendix
Available only for authorised users
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Metadata
Title
Cost-effectiveness of providing patients with information on managing mild low-back symptoms in an occupational health setting
Authors
J. Rantonen
J. Karppinen
A. Vehtari
S. Luoto
E. Viikari-Juntura
M. Hupli
A. Malmivaara
S. Taimela
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-2974-4

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