These researchers investigated return to work and cost-effectiveness
of adding cognitive-behavioral therapy to standard care compared to
standard 3-week inpatient rehabilitation for patients with chronic low
back pain. A cost analysis and a randomized study were done. Outcomes
included days off work due to spinal complaints, quality of life, and
direct and indirect illness-related costs. A total of 409 patients with
chronic low back pain, admitted to a 3-week inpatient rehabilitation,
were randomly assigned to standard care or standard care plus cognitive
behavioral therapy; 382 (93%) completed the trial by time of discharge
from the rehabilitation.
Six months after rehabilitation, patients in the standard care plus
cognitive behavioral therapy group were absent from work an average
of 5.4 days less than patients receiving standard care only. Between
groups, there were no significant differences in quality of life or
in direct medical or nonmedical costs, but patients in the cognitive
behavioral group had lower indirect costs. The investigators note that
while adding a cognitive behavioral component to standard therapy did
not significantly improve the quality of life in these patients, adding
a cognitive behavioral intervention to the standard treatment of inpatient
rehabilitation did reduce work days lost and decrease indirect costs.
Schweikert B, Jacobi E, Seitz R, Cziske R, Ehlert A, Knab J, Leidl R.
Adapted from J Rheumatol. 2006 Dec;33(12):2519-26.
PMID: 17143986 (with full-text link)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
Credit: PubMed, developed by the National Center for Biotechnology Information
(NCBI) at the National
Library of Medicine (NLM).
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