01. tbl. 106. árg. 2020

Economic evaluation of interdisciplinary pain rehabilitation. - One IKR for rehabilitation gives eight IKR back to society

Heilsuhagfræðilegt mat á þverfaglegri verkjameðferð á Reykjalundi. Ein króna í endurhæfingu - átta til baka

Introduction: There is limited research on the long-term benefits of an interdisciplinary pain rehabilitation, even though short-term benefits have been well documented. The present study evaluated the effects of an interdisciplinary pain rehabilitation program with a three-year follow-up. A special emphasis was placed on economic evaluation of the treatment from a societal perspective.

Material and methods: The study was conducted at the chronic pain unit of the Reykjalundur rehabilitation center. Every fifth patient referred to the Reykjalundur Rehabiliation Center pain clinic was randomized to participate in this study. Data was collected over the course of 4,5 years with a three years follow-up. Finally, economic evaluation was conducted at the end of the research.

Results: After treatment patients experienced less pain, fear and avoidance, anxiety and depression symptoms and improved social functioning. Work ability increased from 36% to 47% at the end of rehabilitation and continued to rise to 57% at three year follow-up. Economic evaluation from a societal perspective showed that cost associated with the rehabilitation had leveled out in three years and continued throughout life.

Conclusion: The results indicate that interdisciplinary rehabilitation for chronic pain has a positive impact on function and the experience of pain as well as positive psychosocial effect. An economic evaluation of the treatment shows that the rehabilitation is very cost effective and that each Icelandic krona (IKR) spent is returned eightfold back to society.

Figure I Flow chart of participant recruiting, drop outs and total patients at one and three-year follow-up.

Figure II Percentage of patients returning to work by clinical cut-off score (<29) on FABQ-W from baseline to three years post treatment.

Table I Baseline characteristics of participants by different treatment conditions and clinical cut-offs for depression and anxiety symptoms.

Table II Descriptive statistics (estimated marginal means [M], and standard deviations [SD]) for treatment outcomes for all patient groups from baseline to the three-year follow-up and results from one-way repeated measures ANOVA and effect sizes.

Table III Cost of treatment (in ISK) with and without rehabilitation and the gain in QALY with rehabilitation.

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