Article

OBJECTIVE: To analyze cost-effectiveness of Pain Exposure Physical Therapy
compared to conventional treatment alongside a randomized controlled trial
(NCT00817128) in patients with complex regional pain syndrome type 1, where no
clinical difference was shown between the two groups in an intention-to-treat
analysis. DESIGN: Randomized controlled trial with 9 months follow-up. SETTING:
Patients were recruited from hospitals and general practitioners in the region
around a university hospital. SUBJECTS: A total of 56 patients, 45 (80.4%)
female, were randomized. About 4 patients in the intervention and 11 patients in
the conventional group switched groups. The mean (SD) age was 44.3 (16.6) years,
and in 37 (66.1%) patients, the upper extremity was affected. INTERVENTIONS:
Patients received either Pain Exposure Physical Therapy (maximum of five
sessions), or conventional treatment conforming with the Dutch multidisciplinary
guideline. MAIN MEASURES: For the economic evaluation difference between the
groups in health-related quality of life (quality-adjusted life years (QALYs)),
and the clinical outcomes Impairment level Sum Score-Restricted Version and Pain
Disability was determined based on the intention-to-treat analysis as well as
differences in both healthcare-related costs and travel expenses.
Cost-effectiveness planes were constructed using bootstrapping to compare effects
and costs. RESULTS: No significant effects were found for QALYs (mean difference
= -0.02; 95% confidence interval (CI) -0.10 to 0.04) and clinical outcomes. A
cost minimization analysis showed a significant difference in costs between
groups. The conventional treatment was 64% more expensive than the Pain Exposure
Physical Therapy. CONCLUSION: This economic analysis shows that Pain Exposure
Physical Therapy compared to conventional treatment is cost-effective.

Langue : ANGLAIS