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Cost-Effectiveness of Non-Invasive and Non-Pharmacological Interventions for Low Back Pain: a Systematic Literature Review

Author

Listed:
  • Lazaros Andronis

    (University of Birmingham)

  • Philip Kinghorn

    (University of Birmingham)

  • Suyin Qiao

    (University of Birmingham)

  • David G. T. Whitehurst

    (Simon Fraser University
    University of British Columbia
    Vancouver Coastal Health Research Institute)

  • Susie Durrell

    (Gloucestershire Hospitals National Health Service Foundation Trust)

  • Hugh McLeod

    (University of Birmingham)

Abstract

Background Low back pain (LBP) is a major health problem, having a substantial effect on peoples’ quality of life and placing a significant economic burden on healthcare systems and, more broadly, societies. Many interventions to alleviate LBP are available but their cost effectiveness is unclear. Objectives To identify, document and appraise studies reporting on the cost effectiveness of non-invasive and non-pharmacological treatment options for LBP. Methods Relevant studies were identified through systematic searches in bibliographic databases (EMBASE, MEDLINE, PsycINFO, Cochrane Library, CINAHL and the National Health Service Economic Evaluation Database), ‘similar article’ searches and reference list scanning. Study selection was carried out by three assessors, independently. Study quality was assessed using the Consensus on Health Economic Criteria checklist. Data were extracted using customized extraction forms. Results Thirty-three studies were identified. Study interventions were categorised as: (1) combined physical exercise and psychological therapy, (2) physical exercise therapy only, (3) information and education, and (4) manual therapy. Interventions assessed within each category varied in terms of their components and delivery. In general, combined physical and psychological treatments, information and education interventions, and manual therapies appeared to be cost effective when compared with the study-specific comparators. There is inconsistent evidence around the cost effectiveness of physical exercise programmes as a whole, with yoga, but not group exercise, being cost effective. Conclusions The identified evidence suggests that combined physical and psychological treatments, medical yoga, information and education programmes, spinal manipulation and acupuncture are likely to be cost-effective options for LBP.

Suggested Citation

  • Lazaros Andronis & Philip Kinghorn & Suyin Qiao & David G. T. Whitehurst & Susie Durrell & Hugh McLeod, 2017. "Cost-Effectiveness of Non-Invasive and Non-Pharmacological Interventions for Low Back Pain: a Systematic Literature Review," Applied Health Economics and Health Policy, Springer, vol. 15(2), pages 173-201, April.
    • Handle: RePEc:spr:aphecp:v:15:y:2017:i:2:d:10.1007_s40258-016-0268-8
    DOI: 10.1007/s40258-016-0268-8
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
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    1. NamKwen Kim & Kyung-Min Shin & Eun-Sung Seo & Minjung Park & Hye-Yoon Lee, 2020. "Electroacupuncture with Usual Care for Patients with Non-Acute Pain after Back Surgery: Cost-Effectiveness Analysis Alongside a Randomized Controlled Trial," Sustainability, MDPI, vol. 12(12), pages 1-13, June.
    2. Alberto Benito Rodríguez & Hugo Guillermo Ternavasio-de la Vega & José Ángel Santos Sánchez & Helena Iglesias de Sena & Miguel Marcos & Antonio Javier Chamorro & José Antonio Mirón-Canelo, 2022. "Therapeutic and Preventive Efficacy of an Intervention on Workers in a Back School," IJERPH, MDPI, vol. 19(2), pages 1-14, January.

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