Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 23427
  Title Cost analysis related to dose-response of spinal manipulative therapy for chronic low back pain: Outcomes from a randomized controlled trial [randomized controlled trial]
URL http://www.jmptonline.org/article/S0161-4754%2814%2900066-9/fulltext
Journal J Manipulative Physiol Ther. 2014 Jun;37(5):300-311
Author(s)
Subject(s)
Peer Review Yes
Publication Type Randomized Controlled Trial
Abstract/Notes

Objective: The purpose of this analysis is to report the incremental costs and benefits of different doses of spinal manipulative therapy (SMT) in patients with chronic low back pain (LBP).

Methods: We randomized 400 patients with chronic LBP to receive a dose of 0, 6, 12, or 18 sessions of SMT. Participants were scheduled for 18 visits for 6 weeks and received SMT or light massage control from a doctor of chiropractic. Societal costs in the year after study enrollment were estimated using patient reports of health care use and lost productivity. The main health outcomes were the number of pain-free days and disability-free days. Multiple regression was performed on outcomes and log-transformed cost data.

Results: Lost productivity accounts for most societal costs of chronic LBP. Cost of treatment and lost productivity ranged from $3398 for 12 SMT sessions to $3815 for 0 SMT sessions with no statistically significant differences between groups. Baseline patient characteristics related to increase in costs were greater age (P = .03), greater disability (P = .01), lower quality-adjusted life year scores (P = .01), and higher costs in the period preceding enrollment (P < .01). Pain-free and disability-free days were greater for all SMT doses compared with control, but only SMT 12 yielded a statistically significant benefit of 22.9 pain-free days (P = .03) and19.8 disability-free days (P = .04). No statistically significant group differences in quality-adjusted life years were noted.

Conclusions: A dose of 12 SMT sessions yielded a modest benefit in pain-free and disability-free days. Care of chronic LBP with SMT did not increase the costs of treatment plus lost productivity.

This abstract is reproduced with the permission of the publisher; free full text available at the publisher's site.


 

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