Back schools in occupational health care: design of a randomized controlled trial and cost-effectiveness study

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Abstract

OBJECTIVE: To describe the design of a randomized controlled trial (RCT), including a cost-effectiveness analysis, comparing high-intensity and low-intensity back schools with usual care in occupational health care.

DESIGN: RCT and cost-effectiveness analysis.

STUDY POPULATION: Employees sick-listed for a period of 3 to 6 weeks because of nonspecific low back pain. Interventions High-intensity back school treatment consists of a training program based on the principles of cognitive-behavioral therapy. Low-intensity back school treatment is comparable to the original Swedish Back School. Usual care is provided by the occupational physician according to the Dutch guidelines for the occupational health treatment of patients with low back pain.

OUTCOME MEASURES: Primary outcome measures are return to work, pain intensity, functional status, and general improvement. Secondary outcome measures are kinesiophobia and pain coping. The cost-effectiveness analysis includes the direct and indirect costs. The outcome measures are assessed before randomization and 3, 6, and 12 months after randomization.

CONCLUSION: RCTs of different methodological quality have been conducted to examine the effectiveness of back schools in occupational health care. The large variation in type, content, and intensity of back schools has led to conflicting evidence. Therefore, 2 different forms of back schools are compared. Moreover, this is the first RCT to include a cost-effectiveness analysis comparing low-intensity and high-intensity back schools with usual care in occupational health care.

Original languageEnglish
Pages (from-to)457-65
Number of pages9
JournalJournal of Manipulative and Physiological Therapeutics
Volume27
Issue number7
DOIs
Publication statusPublished - Sep 2004

Cite this

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title = "Back schools in occupational health care: design of a randomized controlled trial and cost-effectiveness study",
abstract = "OBJECTIVE: To describe the design of a randomized controlled trial (RCT), including a cost-effectiveness analysis, comparing high-intensity and low-intensity back schools with usual care in occupational health care.DESIGN: RCT and cost-effectiveness analysis.STUDY POPULATION: Employees sick-listed for a period of 3 to 6 weeks because of nonspecific low back pain. Interventions High-intensity back school treatment consists of a training program based on the principles of cognitive-behavioral therapy. Low-intensity back school treatment is comparable to the original Swedish Back School. Usual care is provided by the occupational physician according to the Dutch guidelines for the occupational health treatment of patients with low back pain.OUTCOME MEASURES: Primary outcome measures are return to work, pain intensity, functional status, and general improvement. Secondary outcome measures are kinesiophobia and pain coping. The cost-effectiveness analysis includes the direct and indirect costs. The outcome measures are assessed before randomization and 3, 6, and 12 months after randomization.CONCLUSION: RCTs of different methodological quality have been conducted to examine the effectiveness of back schools in occupational health care. The large variation in type, content, and intensity of back schools has led to conflicting evidence. Therefore, 2 different forms of back schools are compared. Moreover, this is the first RCT to include a cost-effectiveness analysis comparing low-intensity and high-intensity back schools with usual care in occupational health care.",
keywords = "Adolescent, Adult, Aged, Cost-Benefit Analysis, Humans, Low Back Pain/economics, Middle Aged, Occupational Health Services/economics, Randomized Controlled Trials as Topic/methods",
author = "Heymans, {Martijn W} and {de Vet}, {Henrica C W} and Bongers, {Paulien M} and Koes, {Bart W} and {van Mechelen}, Willem",
year = "2004",
month = "9",
doi = "10.1016/j.jmpt.2004.06.004",
language = "English",
volume = "27",
pages = "457--65",
journal = "Journal of Manipulative and Physiological Therapeutics",
issn = "0161-4754",
publisher = "Mosby Inc.",
number = "7",

}

TY - JOUR

T1 - Back schools in occupational health care

T2 - design of a randomized controlled trial and cost-effectiveness study

AU - Heymans, Martijn W

AU - de Vet, Henrica C W

AU - Bongers, Paulien M

AU - Koes, Bart W

AU - van Mechelen, Willem

PY - 2004/9

Y1 - 2004/9

N2 - OBJECTIVE: To describe the design of a randomized controlled trial (RCT), including a cost-effectiveness analysis, comparing high-intensity and low-intensity back schools with usual care in occupational health care.DESIGN: RCT and cost-effectiveness analysis.STUDY POPULATION: Employees sick-listed for a period of 3 to 6 weeks because of nonspecific low back pain. Interventions High-intensity back school treatment consists of a training program based on the principles of cognitive-behavioral therapy. Low-intensity back school treatment is comparable to the original Swedish Back School. Usual care is provided by the occupational physician according to the Dutch guidelines for the occupational health treatment of patients with low back pain.OUTCOME MEASURES: Primary outcome measures are return to work, pain intensity, functional status, and general improvement. Secondary outcome measures are kinesiophobia and pain coping. The cost-effectiveness analysis includes the direct and indirect costs. The outcome measures are assessed before randomization and 3, 6, and 12 months after randomization.CONCLUSION: RCTs of different methodological quality have been conducted to examine the effectiveness of back schools in occupational health care. The large variation in type, content, and intensity of back schools has led to conflicting evidence. Therefore, 2 different forms of back schools are compared. Moreover, this is the first RCT to include a cost-effectiveness analysis comparing low-intensity and high-intensity back schools with usual care in occupational health care.

AB - OBJECTIVE: To describe the design of a randomized controlled trial (RCT), including a cost-effectiveness analysis, comparing high-intensity and low-intensity back schools with usual care in occupational health care.DESIGN: RCT and cost-effectiveness analysis.STUDY POPULATION: Employees sick-listed for a period of 3 to 6 weeks because of nonspecific low back pain. Interventions High-intensity back school treatment consists of a training program based on the principles of cognitive-behavioral therapy. Low-intensity back school treatment is comparable to the original Swedish Back School. Usual care is provided by the occupational physician according to the Dutch guidelines for the occupational health treatment of patients with low back pain.OUTCOME MEASURES: Primary outcome measures are return to work, pain intensity, functional status, and general improvement. Secondary outcome measures are kinesiophobia and pain coping. The cost-effectiveness analysis includes the direct and indirect costs. The outcome measures are assessed before randomization and 3, 6, and 12 months after randomization.CONCLUSION: RCTs of different methodological quality have been conducted to examine the effectiveness of back schools in occupational health care. The large variation in type, content, and intensity of back schools has led to conflicting evidence. Therefore, 2 different forms of back schools are compared. Moreover, this is the first RCT to include a cost-effectiveness analysis comparing low-intensity and high-intensity back schools with usual care in occupational health care.

KW - Adolescent

KW - Adult

KW - Aged

KW - Cost-Benefit Analysis

KW - Humans

KW - Low Back Pain/economics

KW - Middle Aged

KW - Occupational Health Services/economics

KW - Randomized Controlled Trials as Topic/methods

U2 - 10.1016/j.jmpt.2004.06.004

DO - 10.1016/j.jmpt.2004.06.004

M3 - Article

VL - 27

SP - 457

EP - 465

JO - Journal of Manipulative and Physiological Therapeutics

JF - Journal of Manipulative and Physiological Therapeutics

SN - 0161-4754

IS - 7

ER -