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2017 ; 12
(ä): 28
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Health utilities for chronic low back pain
#MMPMID28878813
Seidler AL
; Rethberg C
; Schmitt J
; Nienhaus A
; Seidler A
J Occup Med Toxicol
2017[]; 12
(ä): 28
PMID28878813
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BACKGROUND: Chronic low back pain (LBP) is a common health problem, with a large
potential for primary prevention. Health utilities (HU) reflect which proportion
of their expected remaining life time individuals would hypothetically trade to
be alleviated of a health condition of interest. A value of 0 means "prefer to
die immediately", a value of 1 means "not willing to trade any life time". The
aim of this cross-sectional study was to assess HU for LBP patients and for
healthy participants and to examine whether HU for LBP are useful indicators to
substantiate preventive and therapeutic decision making. METHODS: Healthy
participants (n?=?126) and LBP patients (n?=?32) were recruited mainly among the
employees of a tertiary care hospital in Germany. Standardized LBP scenarios were
presented to all participants and HU values were assessed using the
time-trade-off method. RESULTS: Median HU for LBP were 0.90 (IQR 0.31) for
participants and 0.93 (IQR 0.10) for LBP patients. Measurements were consistent
across illness severity ratings with HU and with a visual analogue scale (VAS);
in the healthy sample the intraclass correlation coefficient (ICC) was 0.61 (95%
CI 0.23-1.00, F(1125)?=?190, p < .001), in the patient sample the ICC was 0.66
(95% CI?=?0.24-1.00, F(1,31)?=?62, p < .001). 8% of participants reported HU of
1. There was no statistically significant relation between HU and age, income, or
gender. CONCLUSION: On average, participants chose a 7 to 10% shorter life
expectancy to avoid LBP, but almost 1 in 10 participants were not willing to
trade any life years. The results indicate a certain stability of HU due to the
comparability of HU ratings across patients and healthy participants, the
measurement consistency when comparing VAS and HU ratings, and the lack of
association between demographic variables and HU. This underlines the usefulness
of HU for measuring illness severity in comparative health economics evaluations
of preventive and therapeutic measures that address chronic LBP or other
pain-characterized diseases. Future studies should focus on different LBP
intensities and derive stratified HU that reflect the distribution of pain
intensity in the population.
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