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Randomized Controlled Trial
. 2017 Dec 30;67(9):687-695.
doi: 10.1093/occmed/kqx161.

Cost-effectiveness of yoga for managing musculoskeletal conditions in the workplace

N Hartfiel  1 , G Clarke  2 , J Havenhand  3 , C Phillips  4 , R T Edwards  1
Affiliations
Randomized Controlled Trial

Cost-effectiveness of yoga for managing musculoskeletal conditions in the workplace

N Hartfiel et al. Occup Med (Lond). .

Abstract

Background: Back pain and musculoskeletal conditions negatively affect the health-related quality of life (HRQL) of employees and generate substantial costs to employers.

Aims: To assess the cost-effectiveness of yoga for managing musculoskeletal conditions.

Methods: A randomized controlled trial evaluated an 8-week yoga programme, with a 6-month follow-up, for National Health Service (NHS) employees. Effectiveness in managing musculoskeletal conditions was assessed using repeated-measures generalized linear modelling for the Roland-Morris Disability Questionnaire (RDQ) and the Keele STarT Back Screening Tool. Cost-effectiveness was determined using area-under-the-curve linear regression for assessing HRQL from healthcare and societal perspectives. The incremental cost per quality-adjusted life year (QALY) was also calculated. Sickness absence was measured using electronic staff records at 6 months.

Results: There were 151 participants. At 6 months, mean differences between groups favouring yoga were observed for RDQ [-0.63 (95% CI, -1.78, 0.48)], Keele STarT [-0.28 (95% CI, -0.97, 0.07)] and HRQL (0.016 QALY gain). From a healthcare perspective, yoga yielded an incremental cost-effectiveness ratio of £2103 per QALY. Given a willingness to pay for an additional QALY of £20 000, the probability of yoga being cost-effective was 95%. From a societal perspective, yoga was the dominant treatment compared with usual care. At 6 months, electronic staff records showed that yoga participants missed a total of 2 working days due to musculoskeletal conditions compared with 43 days for usual care participants.

Conclusions: Yoga for NHS employees may enhance HRQL, reduce disability associated with back pain, lower sickness absence due to musculoskeletal conditions and is likely to be cost-effective.

Keywords: Back pain; cost-effectiveness; musculoskeletal conditions; occupational health; physical activity; randomized controlled trial; return-on-investment; sickness absence; workplace; yoga.

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Figures

Figure 1.
Figure 1.
Participant flow diagram.
Figure 2.
Figure 2.
Healthcare and societal perspectives: cost-effectiveness planes and cost-effectiveness acceptability curves.
See this image and copyright information in PMC

References

    1. Ward L, Stebbings S, Cherkin D, Baxter GD. Yoga for functional ability, pain and psychosocial outcomes in musculoskeletal conditions: a systematic review and meta-analysis. Musculoskeletal Care 2013;11:203–217. - PubMed
    1. Labour Force Survey. Full Report: Sickness Absence in the Labour Market. London: Office of National Statistics, 2014.
    1. Confederation of British Industry. Fit for Purpose: Absence and Workplace Health Survey http://www.cbi.org.uk/media/2150120/cbi-pfizer_absence___workplace_healt... (7 June 2016, date last accessed).
    1. NHS Employers. NHS Staff Sickness Absence—Latest Figures Show Reduction http://www.nhsemployers.org/news/2014/06/nhs-staff-sickness-absence-late... (21 November 2014, date last accessed).
    1. Chartered Society of Physiotherapists. Physiotherapy Works: OH http://www.csp.org.uk/publications/physiotherapy-works-occupational-health (1 November 2014, date last accessed).

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