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生活方式体力活动干预与工作方式干预相结合对计算机工作者颈部和上肢症状恢复及疼痛减轻的成本效益。

The cost-effectiveness of a lifestyle physical activity intervention in addition to a work style intervention on recovery from neck and upper limb symptoms and pain reduction in computer workers.

机构信息

Body@Work Research Center on Physical Activity, Work and Health, TNO-VUmc, Amsterdam, The Netherlands.

出版信息

Occup Environ Med. 2011 Apr;68(4):265-72. doi: 10.1136/oem.2008.045450. Epub 2010 Sep 23.

DOI:10.1136/oem.2008.045450
PMID:20864468
Abstract

OBJECTIVES

To evaluate the cost-effectiveness of a work style (WS) intervention and a work style plus physical activity (WSPA) intervention in computer workers with neck and upper limb symptoms compared with usual care.

METHODS

An economic evaluation was conducted from an employer's perspective and alongside a randomised controlled trial in which 466 computer workers with neck and upper limb symptoms were randomised to a WS group (N = 152), a WSPA group (N = 156) or a usual care group (N=158). Total costs were compared to the effects on recovery and pain intensity. In the primary analyses, missing effect data were imputed using multiple imputation techniques.

RESULTS

Total costs during the 12-month intervention and follow-up period were €1907 (WS), €2811 (WSPA) and €2310 (usual care). Differences between groups were not statistically significant. Neither intervention was more effective than usual care in improving overall recovery. The WS intervention was more effective than usual care in reducing current pain, average pain and worst pain in the past 4 weeks, but the WSPA intervention was not. The acceptability curve showed that when a company is willing to pay approximately €900 for a 1-point reduction in average pain (scale from 0 to 10), the probability of cost-effectiveness compared to usual care is 95%. Similar results were observed for current and worst pain.

CONCLUSIONS

This study shows that the WS intervention was not cost-effective for improving recovery but was cost-effective for reducing pain intensity, although this reduction was not clinically significant. The WSPA intervention was not cost-effective compared with usual care. Trial registration number ISRCTN87019406.

摘要

目的

评估工作方式(WS)干预和工作方式加体力活动(WSPA)干预在颈肩腕综合征计算机作业工人中的成本效益,与常规治疗相比。

方法

从雇主的角度进行经济评估,并与随机对照试验同时进行,其中 466 名患有颈肩腕综合征的计算机工人被随机分为 WS 组(N=152)、WSPA 组(N=156)或常规护理组(N=158)。将总费用与恢复和疼痛强度的效果进行比较。在主要分析中,使用多重插补技术对缺失的效果数据进行插补。

结果

在 12 个月的干预和随访期间,总费用分别为 WS 组 1907 欧元、WSPA 组 2811 欧元和常规护理组 2310 欧元。组间差异无统计学意义。与常规护理相比,两种干预均不能更有效地改善整体恢复。WS 干预在减少当前疼痛、平均疼痛和过去 4 周内最严重疼痛方面比常规护理更有效,但 WSPA 干预并非如此。接受性曲线表明,当公司愿意为平均疼痛降低 1 分(0 到 10 分)支付约 900 欧元时,与常规护理相比,成本效益的概率为 95%。对于当前和最严重的疼痛也观察到了类似的结果。

结论

这项研究表明,WS 干预在改善恢复方面没有成本效益,但在降低疼痛强度方面具有成本效益,尽管这种减轻程度没有临床意义。与常规护理相比,WSPA 干预不具有成本效益。试验注册号 ISRCTN87019406。

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