Institute of Sport Sciences of the University of Lausanne, Lausanne, Switzerland.
J Rehabil Med. 2010 Oct;42(9):846-52. doi: 10.2340/16501977-0610.
To assess the cost-utility of an exercise programme vs usual care after functional multidisciplinary rehabilitation in patients with chronic low back pain.
Cost-utility analysis alongside a randomized controlled trial.
SUBJECTS/PATIENTS: A total of 105 patients with chronic low back pain.
Chronic low back pain patients completing a 3-week functional multidisciplinary rehabilitation were randomized to either a 3-month exercise programme (n = 56) or usual care (n = 49). The exercise programme consisted of 24 training sessions during 12 weeks. At the end of functional multidisciplinary rehabilitation and at 1-year follow-up quality of life was measured with the SF-36 questionnaire, converted into utilities and transformed into quality--adjusted life years. Direct and indirect monthly costs were measured using cost diaries. The incremental cost-effectiveness ratio was calculated as the incremental cost of the exercise programme divided by the difference in quality-adjusted life years between both groups.
Quality of life improved significantly at 1-year follow-up in both groups. Similarly, both groups significantly reduced total monthly costs over time. No significant difference was observed between groups. The incremental cost-effectiveness ratio was 79,270 euros.
Adding an exercise programme after functional multidisciplinary rehabilitation compared with usual care does not offer significant long-term benefits in quality of life and direct and indirect costs.
评估慢性下背痛患者接受功能康复多学科治疗后，进行运动方案与常规治疗的成本-效用。
随机对照试验的成本-效用分析。
对象/患者：105 名慢性下背痛患者。
完成 3 周功能康复多学科治疗的慢性下背痛患者被随机分配至 3 个月的运动方案（n = 56）或常规治疗（n = 49）。运动方案由 12 周内 24 次训练组成。在功能康复多学科治疗结束和 1 年随访时，使用 SF-36 问卷测量生活质量，并将其转换为效用值和质量调整生命年。使用成本日记测量直接和间接每月成本。增量成本效益比的计算方法为运动方案的增量成本除以两组间质量调整生命年的差异。
两组在 1 年随访时生活质量均显著改善。同样，两组的总月成本随着时间的推移而显著降低。组间未见显著差异。增量成本效益比为 79270 欧元。
与常规治疗相比，在功能康复多学科治疗后增加运动方案并不能在生活质量和直接及间接成本方面带来显著的长期获益。
