OBJECTIVE: To evaluate the cost-effectiveness and cost-utility of a return to work (RTW) program for workers on sick-leave due to low back pain (LBP), comparing a workplace intervention implemented between 2 to 8 weeks of sick-leave with usual care, and a clinical intervention after 8 weeks of sick-leave with usual care. DESIGN: Economic evaluation alongside a randomised controlled trial (RCT). STUDY POPULATION: Workers sick-listed for a period of 2 to 6 weeks due to LBP. INTERVENTIONS: 1. workplace assessment, work modifications and case management). 2. physiotherapy based on operant behavioural principles. 3. usual care: provided by an occupational physician. OUTCOMES: The primary outcome was return to work (RTW). Other outcomes were pain intensity, functional status, quality of life and general health. The economic evaluation was conducted from a societal perspective. Outcomes were assessed at baseline (after 2-6 weeks on sick-leave), and 12 weeks, 26 weeks, and 52 weeks after the first day of sick-leave. RESULTS: The workplace intervention group returned to work 30.0 days (95% CI=[3.1, 51.3]) earlier on average than the usual care group at slightly higher direct costs (ratio of 1 day: 19 euro). Workers in the clinical intervention group that had received usual care in the first 8 weeks returned to work 21.3 days (95% CI= [-74.1, 29.2]) later on average. The group that had received the workplace intervention in the first 8 weeks and the clinical intervention after 8 weeks returned to work 50.9 days (95% CI=[-89.4, -2.7]) later on average. A workplace intervention was more effective than usual care in RTW at slightly higher costs and was equally effective as usual care at equal costs on other outcomes. A clinical intervention was less effective than usual care and associated with higher costs. CONCLUSION: The workplace intervention results in a safe and faster RTW than usual care at reasonable costs for workers on sick-leave for two to six weeks due to LBP.
RCT Entities:
OBJECTIVE: To evaluate the cost-effectiveness and cost-utility of a return to work (RTW) program for workers on sick-leave due to low back pain (LBP), comparing a workplace intervention implemented between 2 to 8 weeks of sick-leave with usual care, and a clinical intervention after 8 weeks of sick-leave with usual care. DESIGN: Economic evaluation alongside a randomised controlled trial (RCT). STUDY POPULATION: Workers sick-listed for a period of 2 to 6 weeks due to LBP. INTERVENTIONS: 1. workplace assessment, work modifications and case management). 2. physiotherapy based on operant behavioural principles. 3. usual care: provided by an occupational physician. OUTCOMES: The primary outcome was return to work (RTW). Other outcomes were pain intensity, functional status, quality of life and general health. The economic evaluation was conducted from a societal perspective. Outcomes were assessed at baseline (after 2-6 weeks on sick-leave), and 12 weeks, 26 weeks, and 52 weeks after the first day of sick-leave. RESULTS: The workplace intervention group returned to work 30.0 days (95% CI=[3.1, 51.3]) earlier on average than the usual care group at slightly higher direct costs (ratio of 1 day: 19 euro). Workers in the clinical intervention group that had received usual care in the first 8 weeks returned to work 21.3 days (95% CI= [-74.1, 29.2]) later on average. The group that had received the workplace intervention in the first 8 weeks and the clinical intervention after 8 weeks returned to work 50.9 days (95% CI=[-89.4, -2.7]) later on average. A workplace intervention was more effective than usual care in RTW at slightly higher costs and was equally effective as usual care at equal costs on other outcomes. A clinical intervention was less effective than usual care and associated with higher costs. CONCLUSION: The workplace intervention results in a safe and faster RTW than usual care at reasonable costs for workers on sick-leave for two to six weeks due to LBP.
Authors: P Loisel; J Lemaire; S Poitras; M-J Durand; F Champagne; S Stock; B Diallo; C Tremblay Journal: Occup Environ Med Date: 2002-12 Impact factor: 4.402
Authors: Hynek Hlobil; J Bart Staal; Maaike Spoelstra; Geertje A M Ariëns; Tjabe Smid; Willem van Mechelen Journal: Scand J Work Environ Health Date: 2005-08 Impact factor: 5.024
Authors: Ingeborg B C Korthals-de Bos; Nynke Smidt; Maurits W van Tulder; Maureen P M H Rutten-van Mölken; Herman J Adèr; Daniëlle A W M van der Windt; Willem J J Assendelft; Lex M Bouter Journal: Pharmacoeconomics Date: 2004 Impact factor: 4.981
Authors: Reuben Escorpizo; Michiel F Reneman; Jan Ekholm; Julie Fritz; Terry Krupa; Sven-Uno Marnetoft; Claude E Maroun; Julietta Rodriguez Guzman; Yoshiko Suzuki; Gerold Stucki; Chetwyn C H Chan Journal: J Occup Rehabil Date: 2011-06
Authors: Keith T Palmer; Elizabeth C Harris; Cathy Linaker; Mary Barker; Wendy Lawrence; Cyrus Cooper; David Coggon Journal: Rheumatology (Oxford) Date: 2011-03-16 Impact factor: 7.580
Authors: Ludeke C Lambeek; Judith E Bosmans; Barend J Van Royen; Maurits W Van Tulder; Willem Van Mechelen; Johannes R Anema Journal: BMJ Date: 2010-11-30
Authors: Sylvia J Vermeulen; Johannes R Anema; Antonius Jm Schellart; Willem van Mechelen; Allard J van der Beek Journal: BMC Public Health Date: 2009-07-02 Impact factor: 3.295