The longitudinal relationships between pain severity and disability versus health-related quality of life and costs among chronic low back pain patients

E. N. Mutubuki*, Y. Beljon, E. T. Maas, F. J.P.M. Huygen, R. W.J.G. Ostelo, M. W. van Tulder, J. M. van Dongen

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

PURPOSE: Previous studies found higher levels of pain severity and disability to be associated with higher costs and lower health-related quality of life. However, these findings were based on cross-sectional data and little is known about the longitudinal relationships between pain severity and disability versus health-related quality of life and costs among chronic low back pain patients. This study aims to cover this knowledge gap by exploring these longitudinal relationships in a consecutive cohort.

METHODS: Data of 6316 chronic low back pain patients were used. Measurements took place at 3, 6, 9, and 12 months. Pain severity (Numeric pain rating scale; range: 0-100), disability (Oswestry disability index; range: 0-100), health-related quality of life (EQ-5D-3L: range: 0-1), societal and healthcare costs (cost questionnaire) were measured. Using linear generalized estimating equation analyses, longitudinal relationships were explored between: (1) pain severity and health-related quality of life, (2) disability and health-related quality of life, (3) pain severity and societal costs, (4) disability and societal costs, (5) pain severity and healthcare costs, and (6) disability and healthcare costs.

RESULTS: Higher pain and disability levels were statistically significantly related with poorer health-related quality of life (pain intensity: - 0.0041; 95% CI - 0.0043 to - 0.0039; disability: - 0.0096; 95% CI - 0.0099 to - 0.0093), higher societal costs (pain intensity: 7; 95% CI 5 to 8; disability: 23; 95% CI 20 to 27) and higher healthcare costs (pain intensity: 3; 95% CI 2 to 4; disability: 9; 95% CI 7 to 11).

CONCLUSION: Pain and disability were longitudinally related to health-related quality of life, societal costs, and healthcare costs. Disability had a stronger association with all outcomes compared to pain.

Original languageEnglish
Pages (from-to)1-13
Number of pages13
JournalQuality of Life Research
Volume29
Issue number1
DOIs
Publication statusE-pub ahead of print - 17 Sep 2019

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Keywords

  • Disability
  • Health-related quality of life
  • Longitudinal analysis
  • Low back pain
  • Pain
  • Societal costs

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