Burden of illness of chronic low back pain in Sweden: a cross-sectional, retrospective study in primary care setting

Mattias Ekman, Sven Jönhagen, Elke Hunsche, Linus Jönsson
Spine 2005 August 1, 30 (15): 1777-85

STUDY DESIGN: Cross-sectional survey of patients with chronic low back pain in primary care setting.

OBJECTIVES: To analyze the health care resource use, productivity loss, and health-related quality of life of patients with chronic low back pain in Sweden.

SUMMARY OF BACKGROUND DATA: Despite the clinical and economic importance of chronic LBP, the overall burden of the disease is not well documented.

METHODS: Cross-sectional data on patients' socio-demographics, disease-related healthcare resource use during the past 6 months, inability to work during the previous 3 months, and quality of life at the time of the study visit were collected using questionnaires completed during an outpatient visit. Patient recruitment and data collection was performed at 14 primary care centers in Sweden. Patients over 18 years of age with chronic LBP present at least 50% of the days during the previous 3 months were included. Regression analysis was used to investigate factors associated with variation in costs.

RESULTS: Based on a sample of 302 patients, the total annual direct costs for chronic LBP per patient were estimated at 3,100 Euros, or 2,900 United States dollars, in 2002 prices, constituting 15% of the total annual LBP costs per patient. The indirect costs (mainly productivity loss because of lost work days) were estimated at 17,600 Euros (16,600 United States dollars) per patient, or 85% of the total LBP costs per patient. Direct and indirect costs were positively correlated with disease severity, disease duration, and female gender. The mean Roland & Morris score was 12.2, and the Medical Outcomes Study 8-Item Short Form physical and mental summary component scores were 35.2 and 41.6, respectively.

CONCLUSIONS: In Sweden, the indirect costs for chronic LBP appear to be substantially higher than the direct costs for pharmaceuticals, medical visits, physiotherapy, andhospitalizations. The high indirect costs indicate that more effective treatments for chronic LBP could potentially lead to cost savings even if the therapy costs were higher.

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