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Randomized trial of a brief physiotherapy intervention compared with usual physiotherapy for neck pain patients: Cost-effectiveness analysis

Published online by Cambridge University Press:  27 February 2006

Andrea Manca ,
David M. Epstein ,
David J. Torgerson ,
Jennifer A. Klaber Moffett ,
Simon Coulton ,
Amanda J. Farrin ,
Seokyung Hahn ,
David A. Jackson  and
Stewart J. Richmond
Andrea Manca
Affiliation:
University of York
David M. Epstein
Affiliation:
University of York
David J. Torgerson
Affiliation:
University of York
Jennifer A. Klaber Moffett
Affiliation:
University of Hull
Simon Coulton
Affiliation:
University of York
Amanda J. Farrin
Affiliation:
University of Leeds
Seokyung Hahn
Affiliation:
Seoul National University College of Medicine
David A. Jackson
Affiliation:
University of Hull
Stewart J. Richmond
Affiliation:
University of Hull
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Abstract

Objectives: To assess the cost-effectiveness of brief physiotherapy intervention versus usual physiotherapy management in patients with neck pain of musculoskeletal origin in the community setting.

Methods: A cost-effectiveness analysis was conducted alongside a multicenter pragmatic randomized controlled clinical trial. Individuals 18 years of age and older with neck pain of more than 2 weeks were recruited from physiotherapy departments with referrals from general practitioners (GPs) in the East Yorkshire and North Lincolnshire regions in the United Kingdom. A total of 139 patients were allocated to the brief intervention, and 129 to the usual physiotherapy. Resource use data were prospectively collected on the number of physiotherapy sessions, hospital stay, specialist, and GP visits. Quality-adjusted life years (QALYs) were estimated using EQ-5D data collected at baseline, 3 and 12 months from the start of the treatment. The economic evaluation was conducted from the U.K. National Health System perspective.

Results: On average, brief intervention produced lower costs (£−68; 95 percent confidence interval [CI], £−103 to £−35) and marginally lower QALYs (−0.001; 95 percent CI, −0.030 to 0.028) compared with usual physiotherapy, resulting in an incremental cost per QALY of £68,000 for usual physiotherapy. These results are sensitive to patients' treatment preferences.

Conclusions: Usual physiotherapy may not be good value for money for the average individual in this trial but could be a cost-effective strategy for those who are indifferent toward which treatment they receive.

Keywords

Neck-pain physical therapyRandomized controlled trialEconomicsQuality of lifeCost-effectiveness analysis
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 22 , Issue 1 , January 2006 , pp. 67 - 75
Copyright
© 2006 Cambridge University Press

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