The (cost-)effectiveness of combined lifestyle interventions for people with persistent low-back pain who are overweight or obese: A systematic review

J. C.J. Huijbers; P. Coenen; G. L.B. Burchell; M. W. Coppieters; I. H.M. Steenhuis; J. H. Van Dieën; B. W. Koes; D. H.R. Kempen; J. R. Anema; I. Kingma; L. Voogt; C. M. Williams; J. M. Van Dongen; H. P. Van der Ploeg; R. W.J.G. Ostelo; G. G.M. Scholten-Peeters

doi:10.1016/j.msksp.2023.102770

The (cost-)effectiveness of combined lifestyle interventions for people with persistent low-back pain who are overweight or obese: A systematic review

J. C.J. Huijbers
, P. Coenen^*
, G. L.B. Burchell
, M. W. Coppieters
, I. H.M. Steenhuis
, J. H. Van Dieën
, B. W. Koes
, D. H.R. Kempen
, J. R. Anema
, I. Kingma
, L. Voogt
, C. M. Williams
, J. M. Van Dongen
, H. P. Van der Ploeg
, R. W.J.G. Ostelo
, G. G.M. Scholten-Peeters

^*Corresponding author for this work

Research output: Contribution to Journal › Review article › Academic › peer-review

Abstract

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 6^th 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.

Original language	English
Article number	102770
Pages (from-to)	1-14
Number of pages	14
Journal	Musculoskeletal Science and Practice
Volume	65
Early online date	4 May 2023
DOIs	https://doi.org/10.1016/j.msksp.2023.102770
Publication status	Published - Jun 2023

Bibliographical note

Funding Information:
None.

Publisher Copyright:
© 2023 The Authors

Funding

None.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Economic evaluation
Healthy lifestyle
Musculoskeletal pain
Obesity
Physical therapy
Rehabilitation

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10.1016/j.msksp.2023.102770

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Cite this

Huijbers, J. C. J., Coenen, P., Burchell, G. L. B., Coppieters, M. W., Steenhuis, I. H. M., Van Dieën, J. H., Koes, B. W., Kempen, D. H. R., Anema, J. R., Kingma, I., Voogt, L., Williams, C. M., Van Dongen, J. M., Van der Ploeg, H. P., Ostelo, R. W. J. G., & Scholten-Peeters, G. G. M. (2023). The (cost-)effectiveness of combined lifestyle interventions for people with persistent low-back pain who are overweight or obese: A systematic review. Musculoskeletal Science and Practice, 65, 1-14. Article 102770. https://doi.org/10.1016/j.msksp.2023.102770

@article{7123dd2626064087ac6ed7e46d4aede9,

title = "The (cost-)effectiveness of combined lifestyle interventions for people with persistent low-back pain who are overweight or obese: A systematic review",

abstract = "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.",

keywords = "Economic evaluation, Healthy lifestyle, Musculoskeletal pain, Obesity, Physical therapy, Rehabilitation",

author = "Huijbers, \{J. C.J.\} and P. Coenen and Burchell, \{G. L.B.\} and Coppieters, \{M. W.\} and Steenhuis, \{I. H.M.\} and \{Van Die{\"e}n\}, \{J. H.\} and Koes, \{B. W.\} and Kempen, \{D. H.R.\} and Anema, \{J. R.\} and I. Kingma and L. Voogt and Williams, \{C. M.\} and \{Van Dongen\}, \{J. M.\} and \{Van der Ploeg\}, \{H. P.\} and Ostelo, \{R. W.J.G.\} and Scholten-Peeters, \{G. G.M.\}",

note = "Funding Information: None. Publisher Copyright: {\textcopyright} 2023 The Authors",

year = "2023",

month = jun,

doi = "10.1016/j.msksp.2023.102770",

language = "English",

volume = "65",

pages = "1--14",

journal = "Musculoskeletal Science and Practice",

issn = "2468-7812",

publisher = "Elsevier BV",

}

Huijbers, JCJ, Coenen, P, Burchell, GLB, Coppieters, MW , Steenhuis, IHM , Van Dieën, JH, Koes, BW, Kempen, DHR, Anema, JR, Kingma, I, Voogt, L, Williams, CM, Van Dongen, JM, Van der Ploeg, HP, Ostelo, RWJG & Scholten-Peeters, GGM 2023, 'The (cost-)effectiveness of combined lifestyle interventions for people with persistent low-back pain who are overweight or obese: A systematic review', Musculoskeletal Science and Practice, vol. 65, 102770, pp. 1-14. https://doi.org/10.1016/j.msksp.2023.102770

The (cost-)effectiveness of combined lifestyle interventions for people with persistent low-back pain who are overweight or obese: A systematic review. / Huijbers, J. C.J.; Coenen, P.; Burchell, G. L.B. et al.
In: Musculoskeletal Science and Practice, Vol. 65, 102770, 06.2023, p. 1-14.

Research output: Contribution to Journal › Review article › Academic › peer-review

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.

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

UR - https://www.scopus.com/pages/publications/85158891477

UR - https://www.scopus.com/pages/publications/85158891477#tab=citedBy

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 -

The (cost-)effectiveness of combined lifestyle interventions for people with persistent low-back pain who are overweight or obese: A systematic review

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

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