Evidence map›Paper›PMID 21118874›Full record

Trial reportBMJ (Clinical research ed.)2010

Effect of integrated care for sick listed patients with chronic low back pain: economic evaluation alongside a randomised controlled trial.

Ludeke C Lambeek, Judith E Bosmans, Barend J Van Royen, Maurits W Van Tulder, Willem Van Mechelen, Johannes R Anema

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 13 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

70 citing papers in PubMed, 13 syntheses or guidelines pooled it.

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  8. Workplace interventions to prevent work disability in workers on sick leave.The Cochrane database of systematic reviews · 2015
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  10. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain.The Cochrane database of systematic reviews · 2014
    Pooled it
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  12. Workplace interventions for neck pain in workers.The Cochrane database of systematic reviews · 2011
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10 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Ludeke C LambeekDepartment of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands.
Judith E Bosmans
Barend J Van Royen
Maurits W Van Tulder
Willem Van Mechelen
Johannes R Anema

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the cost effectiveness, cost utility, and cost-benefit of an integrated care programme compared with usual care for sick listed patients with chronic low back pain.

designEconomic evaluation alongside a randomised controlled trial with 12 months' follow-up.

settingPrimary care (10 physiotherapy practices, one occupational health service, one occupational therapy practice) and secondary care (five hospitals) in the Netherlands, 2005-9.

participants134 adults aged 18-65 sick listed because of chronic low back pain: 66 were randomised to integrated care and 68 to usual care.

interventionsIntegrated care consisted of a workplace intervention based on participatory ergonomics, with involvement of a supervisor, and a graded activity programme based on cognitive behavioural principles. Usual care was provided by general practitioners and occupational physicians according to Dutch guidelines.

main outcome measuresThe primary outcome was duration until sustainable return to work. The secondary outcome was quality adjusted life years (QALYs), measured using EuroQol.

resultsTotal costs in the integrated care group (£13 165, SD £13 600) were significantly lower than in the usual care group (£18 475, SD £13 616). Cost effectiveness planes and acceptability curves showed that integrated care was cost effective compared with usual care for return to work and QALYs gained. The cost-benefit analyses showed that every £1 invested in integrated care would return an estimated £26. The net societal benefit of integrated care compared with usual care was £5744.

conclusionsImplementation of an integrated care programme for patients sick listed with chronic low back pain has a large potential to significantly reduce societal costs, increase effectiveness of care, improve quality of life, and improve function on a broad scale. Integrated care therefore has large gains for patients and society as well as for employers.

Indexed as

AbsenteeismAdolescentAdultAgedChronic DiseaseCost-Benefit AnalysisDelivery of Health Care, IntegratedHealth ResourcesHumansLow Back PainMiddle AgedNetherlandsOccupational TherapyPhysical Therapy ModalitiesQuality-Adjusted Life YearsRehabilitation, Vocational

Identifiers

PMID21118874
PMCPMC2995018

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.