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
BackgroundLow 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.MethodThis 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.ResultThere 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.ConclusionsThe 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 registrationThe randomised trial this research was based upon was prospectively registered on March 25th 2009 with the Australian New Zealand Clinical Trials Registry: ACTRN12609000157279.
BMC Musculoskeletal Disorders