title: Post-implementation surveillance of a non-pharmacological health technology within a national health service.
abstract: OBJECTIVE
  The aim of this study was to describe 8-year results from post-implementation surveillance of neuroreflexotherapy (NRT), a health technology proven effective for treating neck and back pain.
  
  
  METHODS
  Post-implementation surveillance included all patients undergoing NRT across five regions within the Spanish National Health Service (SNHS). Validated methods were used to assess pain, disability, adverse events, use of health resources, and patient satisfaction. Logistic regression models were developed to identify the variables associated with the risk of a pain episode requiring more than one NRT intervention. The number of relapses among discharged patients during the 8-year period was calculated.
  
  
  RESULTS
  Between January 1, 2004, and June 30, 2012, 9,023 patients (median age: 53 years), presenting 11,384 subacute (25.2 percent) and chronic (74.8 percent), neck or back pain episodes, were discharged after receiving NRT. Spinal pain improved in 89 percent of cases, 83 percent abandoned drugs, and 0.02 percent required spine surgery. The only adverse event was skin discomfort (8.0 percent of patients). Number of patient complaints was 0, and answers to a standardized questionnaire reflected a high degree of satisfaction (response rate: 76.7 percent). Of the pain episodes, 18.9 percent required more than one NRT intervention; logistic regression models identified the variables associated with this. Over the 8-year period, the proportion of discharged patients referred for treatment due to relapse at the same level for neck, thoracic, and low back pain, was 16.4 percent, 6.5 percent, and 14.5 percent respectively.
  
  
  CONCLUSIONS
  Post-marketing surveillance for a non-pharmacological technology is feasible within the SNHS. These results support generalizing NRT across the entire SNHS under the current validated application conditions.
authors.affiliation: Ib-Salut.
authors.forename: Carlos
authors.initials: C
authors.lastname: Campillo
authors.affiliation: Regió Sanitària de Barcelona. Consorci Sanitari de Barcelona;Servei Català de la Salut (CatSalut);Parc Sanitari Pere Virgili.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Casamitjana
authors.affiliation: Servicio Madrileño de Salud (SERMAS);Consejería de Sanidad de Madrid.
authors.forename: Fernando
authors.initials: F
authors.lastname: Carrillo-Arias
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP);Unidad de Bioestadística Clínica. Hospital Ramón y Cajal. IRICYS;Spanish Back Pain Research Network.
authors.forename: Ana
authors.initials: A
authors.lastname: Royuela
authors.affiliation: Spanish Back Pain Research Network;Scientific Department,Kovacs Foundation.
authors.forename: Francisco M
authors.initials: FM
authors.lastname: Kovacs
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP);Unidad de Bioestadística Clínica;Hospital Ramón y Cajal;IRICYS;Spanish Back Pain Research Network.
authors.forename: Víctor
authors.initials: V
authors.lastname: Abraira
mesh_terms: D000328:Adult; D001416:Back Pain / Q000628:therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D019547:Neck Pain / Q000628:therapy; D059408:Pain Management / Q000379:methods* / Q000451:nursing*; D011358:Product Surveillance, Postmarketing / Q000379:methods*; D013030:Spain; D013673:Technology Assessment, Biomedical