Cost-effectiveness of physical therapy and general practitioner care for sciatica.
METHODS
An economic evaluation alongside a randomized clinical trial in primary care. A total of 135 patients were randomly allocated to physical therapy added to general practitioners' care (n = 67) or to general practitioners' care alone (n = 68).


OBJECTIVE
To evaluate the cost-effectiveness of physical therapy and general practitioner care for patients with an acute lumbosacral radicular syndrome (LRS, also called sciatica) compared with general practitioner care only.


BACKGROUND
There is a lack of knowledge concerning the cost-effectiveness of physical therapy in patients with sciatica.


METHODS
The clinical outcomes were global perceived effect and quality of life. The direct and indirect costs were measured by means of questionnaires. The follow-up period was 1 year. The Incremental Cost-effectiveness Ratio (ICER) between both study arms was constructed. Confidence intervals for the ICER were calculated using Fieller's method and using bootstrapping.


RESULTS
There was a significant difference on perceived recovery at 1-year follow-up in favor of the physical therapy group. The additional physical therapy did not have an incremental effect on quality of life. At 1-year follow-up, the ICER for the total costs was 6224 euros (95% confidence interval, -10,419, 27,551) per improved patient gained. For direct costs only, the ICER was 837 euros (95% confidence interval, -731, 3186).


CONCLUSIONS
The treatment of patients with LRS with physical therapy and general practitioners'care is not more cost-effective than general practitioners'care alone.
Luijsterburg
Pim A J
PA
Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands. p.luijsterburg@erasmusmc.nl
Lamers
Leida M
LM
Verhagen
Arianne P
AP
Ostelo
Raymond W J G
RW
van den Hoogen
Hans J M M
HJ
Peul
Wilco C
WC
Avezaat
Cees J J
CJ
Koes
Bart W
BW
D000328:Adult; D003362:Cost-Benefit Analysis; D005194:Family Practice / Q000191:economics* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000191:economics* / Q000639:trends; D010821:Physicians, Family / Q000191:economics* / Q000639:trends; D012585:Sciatica / Q000191:economics* / Q000534:rehabilitation / Q000628:therapy*