title: A 5-year follow-up evaluation of the health and economic consequences of an early cognitive behavioral intervention for back pain: a randomized, controlled trial.
abstract: METHODS
  A 5-year follow-up of a randomized, controlled trial.
  
  
  OBJECTIVE
  To evaluate the long-term health and economic consequences of a cognitive behavioral intervention.
  
  
  BACKGROUND
  Linton and Andersson (Spine 2000;25:2825-31) provide 1 of only a few studies on the preventive effects of a cognitive behavioral intervention. The present study is a 5-year follow-up.
  
  
  METHODS
  In the original study, 213 participants were randomized to the cognitive-behavioral group intervention or to usual care plus information on self-care (information comparison group). Of participants, 97% completed a follow-up questionnaire 5 years after the intervention, and supplemental records were obtained from the National Insurance Authority.
  
  
  RESULTS
  The cognitive behavioral group had significantly less pain, was more active, enjoyed better quality of life, and had better general health relative to the information comparison group. There was no difference on health care use. The risk of long-term sick leave was 3 times higher in the information comparison group. The cognitive behavioral group had significantly less lost productivity costs and a lower total cost/y/person (16,514 Swedish kronor) compared to the information comparison group (45,990 Swedish kronor).
  
  
  CONCLUSIONS
  A cognitive-behavioral group intervention produces long-term health and economic benefits. Usual medical care might be improved considerably by implementing these psychologic methods.
authors.affiliation: Department of Occupational and Environmental Medicine, Orebro University Hospital, Orebro University, Orebro, Sweden. steven.linton@bsr.oru.se
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Linton
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Nordin
mesh_terms: D001416:Back Pain / Q000191:economics* / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000191:economics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000191:economics