Cost-effectiveness analysis of app-delivered self-management support (selfBACK) in addition to usual care for people with low back pain in Denmark
Objectives This study aims to investigate the cost-effectiveness of individually tailored self-management support, delivered via the artificial intelligence-based selfBACK app, as an add-on to usual care for people with low back pain (LBP).Design Secondary health-economic analysis of the selfBACK ra...
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| Format: | Article |
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BMJ Publishing Group
2024-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/9/e086800.full |
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| author | Paul Jarle Mork Jan Hartvigsen Karen Søgaard Louise Fleng Sandal Mette Jensen Stochkendahl Line Planck Kongstad Cecilie Krage Øverås Christian Volmar Skovsgaard |
| author_facet | Paul Jarle Mork Jan Hartvigsen Karen Søgaard Louise Fleng Sandal Mette Jensen Stochkendahl Line Planck Kongstad Cecilie Krage Øverås Christian Volmar Skovsgaard |
| author_sort | Paul Jarle Mork |
| collection | DOAJ |
| description | Objectives This study aims to investigate the cost-effectiveness of individually tailored self-management support, delivered via the artificial intelligence-based selfBACK app, as an add-on to usual care for people with low back pain (LBP).Design Secondary health-economic analysis of the selfBACK randomised controlled trial (RCT) with a 9-month follow-up conducted from a Danish national healthcare perspective (primary scenario) and a societal perspective limited to long-term productivity in the form of long-term absenteeism (secondary scenario).Setting Primary care and an outpatient spine clinic in Denmark.Participants A subset of Danish participants in the selfBACK RCT, including 297 adults with LBP randomised to the intervention (n=148) or the control group (n=149).Interventions App-delivered evidence-based, individually tailored self-management support as an add-on to usual care compared with usual care alone among people with LBP.Outcome measures Costs of healthcare usage and productivity loss, quality-adjusted life-years (QALYs) based on the EuroQol-5L Dimension Questionnaire, meaningful changes in LBP-related disability measured by the Roland-Morris Disability Questionnaire (RMDQ) and the Pain Self-Efficacy Questionnaire (PSEQ), costs (healthcare and productivity loss measured in Euro) and incremental cost-effectiveness ratios (ICERs).Results The incremental costs were higher for the selfBACK intervention (mean difference €230 (95% CI −136 to 595)), where ICERs showed an increase in costs of €7336 per QALY gained in the intervention group, and €1302 and €1634 for an additional person with minimal important change on the PSEQ and RMDQ score, respectively. At a cost-effectiveness threshold value of €23250, the selfBACK intervention has a 98% probability of being cost-effective. Analysis of productivity loss was very sensitive, which creates uncertainty about the results from a societal perspective limited to long-term productivity.Conclusions From a healthcare perspective, the selfBACK intervention is likely to represent a cost-effective treatment for people with LBP. However, including productivity loss introduces uncertainty to the results.Trial registration number NCT03798288. |
| format | Article |
| id | doaj-art-0c87d15d35fa4a69a22b46906e31440c |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-0c87d15d35fa4a69a22b46906e31440c2025-08-20T02:40:35ZengBMJ Publishing GroupBMJ Open2044-60552024-09-0114910.1136/bmjopen-2024-086800Cost-effectiveness analysis of app-delivered self-management support (selfBACK) in addition to usual care for people with low back pain in DenmarkPaul Jarle Mork0Jan Hartvigsen1Karen Søgaard2Louise Fleng Sandal3Mette Jensen Stochkendahl4Line Planck Kongstad5Cecilie Krage Øverås6Christian Volmar Skovsgaard75 Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, NorwayCenter for Muscle and Joint Health, Department of Sports and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark3 Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, DenmarkDepartment of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, DenmarkDepartment of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, DenmarkDepartment of Public Health, DaCHE - Danish Centre for Health Economics, University of Southern Denmark, Odense, DenmarkDepartment of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, NorwayDepartment of Public Health, DaCHE - Danish Centre for Health Economics, University of Southern Denmark, Odense, DenmarkObjectives This study aims to investigate the cost-effectiveness of individually tailored self-management support, delivered via the artificial intelligence-based selfBACK app, as an add-on to usual care for people with low back pain (LBP).Design Secondary health-economic analysis of the selfBACK randomised controlled trial (RCT) with a 9-month follow-up conducted from a Danish national healthcare perspective (primary scenario) and a societal perspective limited to long-term productivity in the form of long-term absenteeism (secondary scenario).Setting Primary care and an outpatient spine clinic in Denmark.Participants A subset of Danish participants in the selfBACK RCT, including 297 adults with LBP randomised to the intervention (n=148) or the control group (n=149).Interventions App-delivered evidence-based, individually tailored self-management support as an add-on to usual care compared with usual care alone among people with LBP.Outcome measures Costs of healthcare usage and productivity loss, quality-adjusted life-years (QALYs) based on the EuroQol-5L Dimension Questionnaire, meaningful changes in LBP-related disability measured by the Roland-Morris Disability Questionnaire (RMDQ) and the Pain Self-Efficacy Questionnaire (PSEQ), costs (healthcare and productivity loss measured in Euro) and incremental cost-effectiveness ratios (ICERs).Results The incremental costs were higher for the selfBACK intervention (mean difference €230 (95% CI −136 to 595)), where ICERs showed an increase in costs of €7336 per QALY gained in the intervention group, and €1302 and €1634 for an additional person with minimal important change on the PSEQ and RMDQ score, respectively. At a cost-effectiveness threshold value of €23250, the selfBACK intervention has a 98% probability of being cost-effective. Analysis of productivity loss was very sensitive, which creates uncertainty about the results from a societal perspective limited to long-term productivity.Conclusions From a healthcare perspective, the selfBACK intervention is likely to represent a cost-effective treatment for people with LBP. However, including productivity loss introduces uncertainty to the results.Trial registration number NCT03798288.https://bmjopen.bmj.com/content/14/9/e086800.full |
| spellingShingle | Paul Jarle Mork Jan Hartvigsen Karen Søgaard Louise Fleng Sandal Mette Jensen Stochkendahl Line Planck Kongstad Cecilie Krage Øverås Christian Volmar Skovsgaard Cost-effectiveness analysis of app-delivered self-management support (selfBACK) in addition to usual care for people with low back pain in Denmark BMJ Open |
| title | Cost-effectiveness analysis of app-delivered self-management support (selfBACK) in addition to usual care for people with low back pain in Denmark |
| title_full | Cost-effectiveness analysis of app-delivered self-management support (selfBACK) in addition to usual care for people with low back pain in Denmark |
| title_fullStr | Cost-effectiveness analysis of app-delivered self-management support (selfBACK) in addition to usual care for people with low back pain in Denmark |
| title_full_unstemmed | Cost-effectiveness analysis of app-delivered self-management support (selfBACK) in addition to usual care for people with low back pain in Denmark |
| title_short | Cost-effectiveness analysis of app-delivered self-management support (selfBACK) in addition to usual care for people with low back pain in Denmark |
| title_sort | cost effectiveness analysis of app delivered self management support selfback in addition to usual care for people with low back pain in denmark |
| url | https://bmjopen.bmj.com/content/14/9/e086800.full |
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