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Deep tissue massage, strengthening and stretching exercises, and a combination of both compared with advice to stay active for subacute or persistent non-specific neck pain: A cost-effectiveness analysis of the Stockholm Neck trial (STONE)
Karolinska institutet.
University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. Karolinska institutet.ORCID iD: 0000-0001-5709-5387
Ontario Tech University, Canada.
Karolinska institutet.
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2020 (English)In: Musculoskeletal Science and Practice, ISSN 2468-7812, Vol. 46, article id 102109Article in journal (Refereed) Published
Abstract [en]

Objective To evaluate the cost-effectiveness of deep tissue massage (‘massage’), strengthening and stretching exercises (‘exercises’) or a combination of both (‘combined therapy’) in comparison with advice to stay active (‘advice’) for subacute and persistent neck pain, from a societal perspective.

Methods We conducted a cost-effectiveness analysis alongside a four-arm randomized controlled trial of 619 participants followed-up for one year. Health-related quality of life was measured using EQ-5D-3L and costs were calculated from baseline to one year. The interventions were ranked according to quality adjusted life years (QALYs) in a cost-consequence analysis. Thereafter, an incremental cost per QALY was calculated.

Results In the cost-consequence analysis, in comparison with advice, exercises resulted in higher QALY gains, and massage and the combined therapy were more costly and less beneficial. Exercises may be a cost-effective treatment compared with advice to stay active if society is willing to pay 17 640 EUR per QALY. However, differences in QALY gains were minimal; on average, participants in the massage group, spent a year in a state of health valued at 0.88, exercises: 0.89, combined therapy: 0.88 and, advice: 0.88.

Conclusions Exercises are cost-effective compared to advice given that the societal willingness to pay is above 17 640 EUR per year in full health gained. Massage and a combined therapy are not cost-effective. While exercise appeared to have the best cost/benefit profile, even this treatment had only a modest benefit and treatment innovation is needed. Advice to stay active remains as a good therapeutic alternative from an economical perspective.

Place, publisher, year, edition, pages
Elsevier, 2020. Vol. 46, article id 102109
Keywords [en]
Neck pain, Cost-effectiveness, Health economic evaluation, Medical economics, Complementary therapies, Quality adjusted life years
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:hig:diva-31606DOI: 10.1016/j.msksp.2020.102109ISI: 000520868700006PubMedID: 31989965Scopus ID: 2-s2.0-85078120878OAI: oai:DiVA.org:hig-31606DiVA, id: diva2:1390056
Available from: 2020-01-31 Created: 2020-01-31 Last updated: 2020-04-09Bibliographically approved

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Aboagye, Emmanuel

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