TY - JOUR
T1 - The (cost-)effectiveness of combined lifestyle interventions for people with persistent low-back pain who are overweight or obese
T2 - A systematic review
AU - Huijbers, J. C.J.
AU - Coenen, P.
AU - Burchell, G. L.B.
AU - Coppieters, M. W.
AU - Steenhuis, I. H.M.
AU - Van Dieën, J. H.
AU - Koes, B. W.
AU - Kempen, D. H.R.
AU - Anema, J. R.
AU - Kingma, I.
AU - Voogt, L.
AU - Williams, C. M.
AU - Van Dongen, J. M.
AU - Van der Ploeg, H. P.
AU - Ostelo, R. W.J.G.
AU - Scholten-Peeters, G. G.M.
N1 - Funding Information:
None.
Publisher Copyright:
© 2023 The Authors
PY - 2023/6
Y1 - 2023/6
N2 - Introduction: Lifestyle factors are expected to contribute to the persistence and burden of low-back pain (LBP). However, there are no systematic reviews on the (cost-)effectiveness of combined lifestyle interventions for overweight or obese people with LBP. Aim: To assess whether combined lifestyle interventions are (cost-)effective for people with persistent LBP who are overweight or obese, based on a systematic review. Design: Systematic review Method: PubMed, Cochrane, Embase, CINAHL, PsycINFO and the Wiley/Cochrane Library were searched from database inception till January 6th 2023. Two independent reviewers performed study selection, data-extraction and risk of bias scoring using the Cochrane RoB tool 2 and/or the Consensus Health Economic Criteria list. GRADE was used to assess the level of certainty of the evidence. Results: In total 2510 records were screened, and 4 studies on 3 original RCTs with 216 participants were included. Low certainty evidence (1 study) showed that combined lifestyle interventions were not superior to usual care for physical functioning, pain and lifestyle outcomes. Compared to usual care, moderate certainty evidence showed that healthcare (-$292, 95%CI: 872; −33), medication (-$30, 95% CI -65; −4) and absenteeism costs (-$1000, 95%CI: 3573; −210) were lower for the combined lifestyle interventions. Conclusion: There is low certainty evidence from 3 studies with predominantly small sample sizes, short follow-up and low intervention adherence that combined lifestyle interventions are not superior to physical functioning, pain and lifestyle outcomes compared to usual care, but are likely to be cost-effective.
AB - Introduction: Lifestyle factors are expected to contribute to the persistence and burden of low-back pain (LBP). However, there are no systematic reviews on the (cost-)effectiveness of combined lifestyle interventions for overweight or obese people with LBP. Aim: To assess whether combined lifestyle interventions are (cost-)effective for people with persistent LBP who are overweight or obese, based on a systematic review. Design: Systematic review Method: PubMed, Cochrane, Embase, CINAHL, PsycINFO and the Wiley/Cochrane Library were searched from database inception till January 6th 2023. Two independent reviewers performed study selection, data-extraction and risk of bias scoring using the Cochrane RoB tool 2 and/or the Consensus Health Economic Criteria list. GRADE was used to assess the level of certainty of the evidence. Results: In total 2510 records were screened, and 4 studies on 3 original RCTs with 216 participants were included. Low certainty evidence (1 study) showed that combined lifestyle interventions were not superior to usual care for physical functioning, pain and lifestyle outcomes. Compared to usual care, moderate certainty evidence showed that healthcare (-$292, 95%CI: 872; −33), medication (-$30, 95% CI -65; −4) and absenteeism costs (-$1000, 95%CI: 3573; −210) were lower for the combined lifestyle interventions. Conclusion: There is low certainty evidence from 3 studies with predominantly small sample sizes, short follow-up and low intervention adherence that combined lifestyle interventions are not superior to physical functioning, pain and lifestyle outcomes compared to usual care, but are likely to be cost-effective.
KW - Economic evaluation
KW - Healthy lifestyle
KW - Musculoskeletal pain
KW - Obesity
KW - Physical therapy
KW - Rehabilitation
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U2 - 10.1016/j.msksp.2023.102770
DO - 10.1016/j.msksp.2023.102770
M3 - Review article
SN - 2468-7812
VL - 65
SP - 1
EP - 14
JO - Musculoskeletal Science and Practice
JF - Musculoskeletal Science and Practice
M1 - 102770
ER -
