Personal and Societal Impact of Low Back Pain: The Groningen Spine Cohort

doi:10.1097/BRS.0000000000003174

. 2019 Dec 15;44(24):E1443-E1451.

doi: 10.1097/BRS.0000000000003174.

Personal and Societal Impact of Low Back Pain: The Groningen Spine Cohort

Alisa L Dutmer¹, Henrica R Schiphorst Preuper^{1

2}, Remko Soer^{2

3}, Sandra Brouwer⁴, Ute Bültmann⁴, Pieter U Dijkstra^{1

5}, Maarten H Coppes^{2

6}, Patrick Stegeman², Erik Buskens⁷, Antoinette D I van Asselt⁷, André P Wolff^{2

8}, Michiel F Reneman¹

Affiliations

¹ University of Groningen, University Medical Center Groningen, Department of Rehabilitation, Groningen, The Netherlands.
² University of Groningen, University Medical Center Groningen, Groningen Spine Center, Groningen, The Netherlands.
³ Saxion University of Applied Sciences, Expertise Center of Health and Movement, Enschede, The Netherlands.
⁴ University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, The Netherlands.
⁵ University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Groningen, The Netherlands.
⁶ University of Groningen, University Medical Center Groningen, Department of Neurosurgery, Groningen, The Netherlands.
⁷ University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands.
⁸ University of Groningen, University Medical Center Groningen, Department of Anaesthesiology, Pain Center, Groningen, The Netherlands.

PMID: 31369481
DOI: 10.1097/BRS.0000000000003174

Personal and Societal Impact of Low Back Pain: The Groningen Spine Cohort

Alisa L Dutmer et al. Spine (Phila Pa 1976). 2019.

. 2019 Dec 15;44(24):E1443-E1451.

doi: 10.1097/BRS.0000000000003174.

Authors

Affiliations

¹ University of Groningen, University Medical Center Groningen, Department of Rehabilitation, Groningen, The Netherlands.
² University of Groningen, University Medical Center Groningen, Groningen Spine Center, Groningen, The Netherlands.
³ Saxion University of Applied Sciences, Expertise Center of Health and Movement, Enschede, The Netherlands.
⁴ University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, The Netherlands.
⁵ University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Groningen, The Netherlands.
⁶ University of Groningen, University Medical Center Groningen, Department of Neurosurgery, Groningen, The Netherlands.
⁷ University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands.
⁸ University of Groningen, University Medical Center Groningen, Department of Anaesthesiology, Pain Center, Groningen, The Netherlands.

PMID: 31369481
DOI: 10.1097/BRS.0000000000003174

Abstract

Study design: Cross-sectional study.

Objective: The aim of this study was to study the personal and societal impact of low back pain (LBP) in patients admitted to a multidisciplinary spine center.

Summary of background data: The socioeconomic burden of LBP is very high. A minority of patients visit secondary or tertiary care because of severe and long-lasting complaints. This subgroup may account for a major part of disability and costs, yet could potentially gain most from treatment. Currently, little is known about the personal and societal burden in patients with chronic complex LBP visiting secondary/tertiary care.

Methods: Baseline data were acquired through patient-reported questionnaires and health insurance claims. Primary outcomes were LBP impact (Impact Stratification, range 8-50), functioning (Pain Disability Index, PDI; 0-70), quality of life (EuroQol-5D, EQ5D; -0.33 to 1.00), work ability (Work Ability Score, WAS; 0-10), work participation, productivity costs (Productivity Cost Questionnaire), and healthcare costs 1 year before baseline. Healthcare costs were compared with matched primary and secondary care LBP samples. Descriptive and inferential statistics were applied.

Results: In total, 1502 patients (age 46.3 ± 12.8 years, 57% female) were included. Impact Stratification was 35.2 ± 7.5 with severe impact (≥35) for 58% of patients. PDI was 38.2 ± 14.1, EQ5D 0.39 (interquartile range, IQR: 0.17-0.72); WAS 4.0 (IQR: 1.0-6.0) and 17% were permanently work-disabled. Mean total health care costs (&OV0556;4875, 95% confidence interval [CI]: 4309-5498) were higher compared to the matched primary care sample (n = 4995) (&OV0556;2365, 95% CI: 2219-2526, P < 0.001), and similar to the matched secondary care sample (n = 4993) (&OV0556;4379, 95% CI: 4180-4590). Productivity loss was estimated at &OV0556;4315 per patient (95% CI: 3898-4688) during 6 months.

Conclusion: In patients seeking multidisciplinary spine care, the personal and societal impact of LBP is very high. Specifically, quality of life and work ability are poor and health care costs are twice as high compared to patients seeking primary LBP care.

Level of evidence: 3.

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References

1. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the global burden of disease study 2015. Lancet 2016; 388:1545–1602.
1. Picavet HS, Schouten JS. Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC(3)-study. Pain 2003; 102:167–178.
1. Lambeek LC, van Tulder MW, Swinkels IC, et al. The trend in total cost of back pain in the Netherlands in the period 2002 to 2007. Spine (Phila Pa 1976) 2011; 36:1050–1058.
1. Hansson EK, Hansson TH. The costs for persons sick-listed more than one month because of low back or neck problems. A two-year prospective study of Swedish patients. Eur Spine J 2005; 14:337–345.
1. Norlund AI, Waddel G. Nachemson AL, Jonsson E. Cost of back pain in some OECD countries. Neck And back pain: The Scientific Evidence of Causes, Diagnosis Treatment. Philadelphia (PA): Lippincott Williams, Wilkins; 2000. 421–425.

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[1] GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the global burden of disease study 2015. Lancet 2016; 388:1545–1602.

[2] GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the global burden of disease study 2015. Lancet 2016; 388:1545–1602.

[3] Picavet HS, Schouten JS. Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC(3)-study. Pain 2003; 102:167–178.

[4] Picavet HS, Schouten JS. Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC(3)-study. Pain 2003; 102:167–178.

[5] Lambeek LC, van Tulder MW, Swinkels IC, et al. The trend in total cost of back pain in the Netherlands in the period 2002 to 2007. Spine (Phila Pa 1976) 2011; 36:1050–1058.

[6] Lambeek LC, van Tulder MW, Swinkels IC, et al. The trend in total cost of back pain in the Netherlands in the period 2002 to 2007. Spine (Phila Pa 1976) 2011; 36:1050–1058.

[7] Hansson EK, Hansson TH. The costs for persons sick-listed more than one month because of low back or neck problems. A two-year prospective study of Swedish patients. Eur Spine J 2005; 14:337–345.

[8] Hansson EK, Hansson TH. The costs for persons sick-listed more than one month because of low back or neck problems. A two-year prospective study of Swedish patients. Eur Spine J 2005; 14:337–345.

[9] Norlund AI, Waddel G. Nachemson AL, Jonsson E. Cost of back pain in some OECD countries. Neck And back pain: The Scientific Evidence of Causes, Diagnosis Treatment. Philadelphia (PA): Lippincott Williams, Wilkins; 2000. 421–425.

[10] Norlund AI, Waddel G. Nachemson AL, Jonsson E. Cost of back pain in some OECD countries. Neck And back pain: The Scientific Evidence of Causes, Diagnosis Treatment. Philadelphia (PA): Lippincott Williams, Wilkins; 2000. 421–425.

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Personal and Societal Impact of Low Back Pain: The Groningen Spine Cohort

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Personal and Societal Impact of Low Back Pain: The Groningen Spine Cohort

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