HTA paper on back pain published in The Lancet
News release from NETSCC, HTA
26 February 2010
A Cognitive Behavioural Approach (CBA) for the treatment of low back pain is both clinically and cost-effective finds new NIHR HTA research published in The Lancet today (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2962164-4/fulltext).
The management of low back pain (LBP) is a challenge to the NHS. Previous studies have shown the importance of psychological and social risk factors in the development of LBP.
These factors include psychological distress, occupational factors such as work dissatisfaction, and poor health behaviours such as physical inactivity. This study was designed to determine whether a CBA, designed to address these risk factors is effective in preventing disability, work absence and health services use associated with LBP.
The £1million trial led by Professor Sallie Lamb of the University of Warwick, recruited over 700 participants from 56 general practices across seven regions in England who had back pain present for at least six weeks. They were randomised, with one group receiving active management care from the general practice, and the other group receiving active management care together with a course involving CBA.
The results of this study demonstrated the long-term clinical and cost-effectiveness of CBA in treating LBP. Sixty per cent of the CBA arm compared with 31 per cent of the active management arm reported some or complete recovery. The economic analysis indicated that this intervention could be extremely cost-effective from an NHS and a healthcare perspective, halving the cost of competing interventions for LBP.
“In contrast to previous studies, the benefits observed in this trial were maintained and increased over the long term “, says Professor Lamb. “These outcomes are likely to make this intervention attractive to patients, clinicians and purchasers”.
The full results of this study will publish in HTA journal series in spring 2011. For more details visit http://www.hta.ac.uk/1358
Notes for editors
1. The National Institute for Health Research Health Technology Assessment (NIHR HTA) programme commissions research about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest NIHR programme and publishes the results of its research in the Health Technology Assessment journal, with over 530 issues published to date. The journal’s 2009 Impact Factor (6.91) ranked it in the top 10% of medical and health-related journals. All issues are available for download free of charge from the website, www.hta.ac.uk
2. The National Institute for Health Research provides the framework through which the research staff and research infrastructure of the NHS in England is positioned, maintained and managed as a national research facility. The NIHR provides the NHS with the support and infrastructure it needs to conduct first-class research funded by the Government and its partners alongside high-quality patient care, education and training. Its aim is to support outstanding individuals (both leaders and collaborators), working in world class facilities (both NHS and university), conducting leading edge research focused on the needs of patients. www.nihr.ac.uk
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