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Title: Treatment efficacy, clinical utility, and cost-effectiveness of multidisciplinary biopsychosocial rehabilitation treatments for persistent low back pain : a systematic review
Authors : Salathé, Cornelia Rolli
Melloh, Markus
Crawford, Rebecca
Scherrer, Stephanie
Boos, Norbert
Elfering, Achim
Published in : Global Spine Journal
Volume(Issue) : 8
Issue : 8
Pages : 872
Pages to: 886
Publisher / Ed. Institution : AOSpine
Issue Date: 2018
License (according to publishing contract) : CC BY-NC-ND 4.0: Attribution - Non commercial - No derivatives 4.0 International
Type of review: Peer review (publication)
Language : English
Subjects : Persistent low back pain; Systematic review; Cost-effectiveness; Treatment utility; Efficacy; Cognitive behavioral therapy; Multidisciplinary rehabilitation
Subject (DDC) : 617.5: Orthopaedic surgery
Abstract: Study Design: Systematic review Objectives: To review the current literature on the treatment efficacy, clinical utility, and cost-effectiveness of multidisciplinary biopsychosocial rehabilitation (MBR) for patients suffering from persistent (nonspecific) lower back pain (LBP) in relation to pain intensity, disability, health-related quality of life, and work ability/sick leave. Methods: We carried out a systematic search of Web of Science, Cochrane Library, PubMed Central, EMBASE, and PsycINFO for English- and German-language literature published between January 2010 and July 2017. Study selection consisted of exclusion and inclusion phases. After screening for duplication, studies were excluded on the basis of criteria covering study design, number of participants, language of publication, and provision of information about the intervention. All the remaining articles dealing with the efficacy, utility, or cost-effectiveness of intensive (more than 25 hours per week) MBR encompassing at least 3 health domains and cognitive behavioral therapy–based psychological education were included. Results: The search retrieved 1199 publications of which 1116 were duplicates or met the exclusion criteria. Seventy of the remaining 83 articles did not meet the inclusion criteria; thus 13 studies were reviewed. All studies reporting changes in pain intensity or disability over 12 months after MBR reported moderate effect sizes and/or p-values for both outcomes. The effects on health-related quality of life were mixed, but MBR substantially reduced costs. Overall MBR produced an enduring improvement in work ability despite controversy and variable results. Conclusions: MBR is an effective treatment for nonspecific LBP, but there is room for improvement in cost-effectiveness and impact on sick leave, where the evidence was less compelling.
Departement: Health Professions
Organisational Unit: Institute of Health Sciences (IGW)
Publication type: Article in scientific journal
DOI : 10.21256/zhaw-4990
ISSN: 2192-5682
Appears in Collections:Publikationen Gesundheit

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