PT  - JOURNAL ARTICLE
AU  - Schweikert, Bernd
AU  - Jacobi, Eckart
AU  - Seitz, Robert
AU  - Cziske, Reinhard
AU  - Ehlert, Antje
AU  - Knab, Julia
AU  - Leidl, Reiner
TI  - Effectiveness and cost-effectiveness of adding a cognitive behavioral treatment to the rehabilitation of chronic low back pain.
DP  - 2006 Dec 01
TA  - The Journal of Rheumatology
PG  - 2519--2526
VI  - 33
IP  - 12
4099  - http://www.jrheum.org/content/33/12/2519.short
4100  - http://www.jrheum.org/content/33/12/2519.full
SO  - J Rheumatol2006 Dec 01; 33
AB  - OBJECTIVE: To investigate return to work and cost-effectiveness of the addition of cognitive-behavioral treatment to standard therapy compared to standard 3-week inpatient rehabilitation for patients with chronic low back pain. METHODS: A prospective economic evaluation alongside a randomized controlled trial was performed. Outcomes included days off work due to spinal complaints, health-related quality of life, and direct and indirect disease-related costs. RESULTS: A total of 409 patients with chronic low back pain, who were admitted to a 3-week inpatient rehabilitation, were randomly assigned to usual care or usual care plus cognitive behavioral treatment. Average incremental costs for psychological treatment during rehabilitation were Euros 127 (95% CI 125.6, 130.9; p < 0.001). Six months after rehabilitation, patients in the intervention group were absent from work an average of 5.4 (95% CI -1.4, 12.1; p = 0.12) days less than patients receiving usual treatment. Between groups, there were no significant differences in quality-adjusted life-years gained or in direct medical or nonmedical costs. The cognitive behavioral treatment showed lower indirect costs: Euros 751 (95% CI -145, 1641; p = 0.097). CONCLUSION: Adding a cognitive behavioral component to standard therapy may reduce work days lost and thus decrease indirect costs. From a societal perspective, the cost of the psychological treatment was compensated by lower indirect costs.