Costs Associated With Treatment of Chronic Low Back Pain: An Analysis of the UK General Practice Research Database

Hong, Jihyung; Reed, Catherine; Novick, Diego; Happich, Michael

doi:10.1097/brs.0b013e318276450f

Cited by 210Musculoskeletal pain and rehabilitationSpine and Intervertebral Disc PathologyHealthcare cost, quality, practices

Costs Associated With Treatment of Chronic Low Back Pain: An Analysis of the UK General Practice Research Database

Hong, Jihyung, Reed, Catherine, Novick, Diego, Happich, Michael·2013·Spine

DOI 10.1097/brs.0b013e318276450f

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Abstract

STUDY DESIGN: Retrospective cohort study of health care costs associated with the treatment of chronic low back pain (CLBP) in the United Kingdom. OBJECTIVE: To assess 12-month health care costs associated with the treatment of CLBP, using the UK General Practice Research Database. SUMMARY OF BACKGROUND DATA: CLBP is a common health problem. METHODS: Data were obtained from the General Practice Research Database, a computerized database of UK primary care patient data. Patients with CLBP were identified for the study period (January 1, 2007, to December 31, 2009) using diagnostic records and pain relief prescriptions (n = 64,167), and 1:1 matched to patients without CLBP (n = 52,986) on the basis of age, sex, and general practitioner's practice. Index date was defined as the first date of CLBP record; the same index date was assigned to matched controls. Multivariate analyses were performed to compare resource use costs (2009 values) in the 12 months after the index date between patients with and without CLBP. A sensitivity analysis was carried out with a more stringent definition for the control group by excluding a broad range of pain conditions. RESULTS: Total health care costs for patients with CLBP were double those of the matched controls (£1074 vs. £516; P < 0.05). Of the cost difference, 58.8% was accounted for by general practitioner's consultations, 22.3% by referrals to secondary care, and the rest by pain relief medications. The sensitivity analysis revealed an even greater cost difference between the 2 groups (£1052 vs. £304; P < 0.05). Because of the use of a retrospective administrative claims database, this study is subject to selection bias between study cohorts, misidentification of comorbidities, and an inability to confirm adherence to therapy or assess indirect costs and costs of over-the-counter medications. CONCLUSION: Our findings confirm the substantial economic burden of CLBP, even with direct costs only.

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Patients with chronic pain combine appointments with their general practitioner, emergency services, and specialized pain clinics for treatment of their pain and related symptoms.
“For patients with chronic pain, an added problem is that patients combine appointments with their general practitioner, emergency services and specialized pain clinics for the treatment of their pain and related symptoms [33].”
From Telemonitoring in Chronic Pain Management Using Smartphone Apps: A Randomized Controlled Trial Comparing Usual Assessment against App-Based Monitoring with and without Clinical Alarms (2020) · cites this paper as [33]

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Authors: Hong, J., Reed, C., Novick, D., & Happich, M.
Affiliations: London School of Economics and Political Science (GB)
Eli Lilly (Germany) (DE)
Corresponding author: Hong, Jihyung
ORCID: Reed, Catherine
Venue: Spine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2013-01
Volume: 38
Issue: 1
Pages: 75-82
ISSN: 0362-2436 (ISSN-L)
DOI: 10.1097/brs.0b013e318276450f
OpenAlex: W2039594564
Cited by: 210
References: 20
Citations by year: 2026: 6 · 2025: 17 · 2024: 16 · 2023: 19 · 2022: 13 · 2021: 19 · 2020: 17 · 2019: 21 · 2018: 18 · 2017: 16 · 2016: 17 · 2015: 17 · 2014: 12 · 2013: 2
FWCI: 7.28
Type: journal article
Language: en
Open access: closed
Locations: Spine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
Keywords: chronic low back pain, health care costs, economic burden, primary care visits, secondary care referral, resource utilization (health care), United Kingdom
MeSH terms: Adolescent, Adult, Aged, Aged, 80 and over, Female, United Kingdom, Humans, Male, Middle Aged, Retrospective Studies, Cohort Studies, Databases, Factual, Health Care Costs, Low Back Pain, Young Adult, General Practice, Chronic Pain

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Costs Associated With Treatment of Chronic Low Back Pain: An Analysis of the UK General Practice Research Database

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