Pain Exposure Physical Therapy versus conventional treatment in complex regional pain syndrome type 1-a cost-effectiveness analysis alongside a randomized controlled trial
| Autor: | Eddy M. M. Adang, Karlijn J Barnhoorn, J. Bart Staal, Jan Paul M. Frölke, Robert van Dongen, Frank P Klomp, Henk van de Meent, Maria W.G. Nijhuis-van der Sanden |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Cost effectiveness Cost-Benefit Analysis Physical Therapy Sports Therapy and Rehabilitation law.invention Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans In patient 030212 general & internal medicine cost-effectiveness Physical Therapy Modalities Netherlands business.industry Rehabilitation Conventional treatment complex regional pain syndrome Evaluative Studies Cost-effectiveness analysis University hospital medicine.disease Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] Reflex Sympathetic Dystrophy Complex regional pain syndrome randomized controlled trial Physical therapy Quality of Life Female business 030217 neurology & neurosurgery |
| Zdroj: | Clinical Rehabilitation, 32, 790-798 Clinical Rehabilitation Clinical Rehabilitation, 32, 6, pp. 790-798 |
| ISSN: | 0269-2155 |
| Popis: | Contains fulltext : 193431.pdf (Publisher’s version ) (Open Access) OBJECTIVE: To analyze cost-effectiveness of Pain Exposure Physical Therapy compared to conventional treatment alongside a randomized controlled trial (NCT00817128) in patients with complex regional pain syndrome type 1, where no clinical difference was shown between the two groups in an intention-to-treat analysis. DESIGN: Randomized controlled trial with 9 months follow-up. SETTING: Patients were recruited from hospitals and general practitioners in the region around a university hospital. SUBJECTS: A total of 56 patients, 45 (80.4%) female, were randomized. About 4 patients in the intervention and 11 patients in the conventional group switched groups. The mean (SD) age was 44.3 (16.6) years, and in 37 (66.1%) patients, the upper extremity was affected. INTERVENTIONS: Patients received either Pain Exposure Physical Therapy (maximum of five sessions), or conventional treatment conforming with the Dutch multidisciplinary guideline. MAIN MEASURES: For the economic evaluation difference between the groups in health-related quality of life (quality-adjusted life years (QALYs)), and the clinical outcomes Impairment level Sum Score-Restricted Version and Pain Disability was determined based on the intention-to-treat analysis as well as differences in both healthcare-related costs and travel expenses. Cost-effectiveness planes were constructed using bootstrapping to compare effects and costs. RESULTS: No significant effects were found for QALYs (mean difference = -0.02; 95% confidence interval (CI) -0.10 to 0.04) and clinical outcomes. A cost minimization analysis showed a significant difference in costs between groups. The conventional treatment was 64% more expensive than the Pain Exposure Physical Therapy. CONCLUSION: This economic analysis shows that Pain Exposure Physical Therapy compared to conventional treatment is cost-effective. |
| Databáze: | OpenAIRE |
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