Assessing the feasibility of collecting health care resource use data from general practices for use in an economic evaluation of vocational rehabilitation for back pain.

The cost of back pain to the UK economy is considerable inrespect of both direct and indirect health care. In 1998, the directhealth care costs alone were estimated as £1632 million [1]. Asa result, the inclusion of health economic outcomes for muscu-loskeletal disorders is an agreed research priority for non-pharmalogical therapies [2] and vocational rehabilitation [3]. Establishing accurate and feasible methods of data collection istherefore essential in studies measuring the effectiveness of backpain rehabilitation.Economic evaluations estimate the costs and beneﬁts of two ormore competing interventions in order to inform resource alloca-tion decision making about the likely value for money. In a ﬁxedbudget national health service, it is important to undertake suchevaluations in order to maximize the efﬁcient use of resourcesandpatientoutcomes.However,theusefulnessofsuchevaluationsdepends on both the quality and availability of the necessary dataupon which they are based. Resource use data and outcomes datacan be collected in a number of ways, including patient self-reportquestionnaires, diaries and interviews, clinical report forms andpatient records. Several studies have investigated the use of alter-native ways of collecting resource use data but ﬁndings are mixedas to the most reliable method [4–7]. However, very few of theseeconomicevaluationsdescribehowsuchdatacollectiontoolsweredeveloped, or have compared case notes with self-report for backpain [8]. This study describes pilot work conducted in preparation for afeasibility randomized controlled trial of vocational rehabilitationfor low back pain. In the trial, patients were to be recruited from amultidisciplinary group rehabilitation programme for back pain(The Nottingham Back and Pain Team) and randomized into oneof two groups; routine group rehabilitation, or routine group reha-bilitation plus an individually targeted vocational intervention.Aneconomic evaluation was proposed to estimate the comparativecosts and outcomes of the interventions from a national healthservice and social service perspective, the patient perspectivebeing presented separately.Health care resource data are often collected throughself-report, but such methods may not be accurate due to,for example, poor completion rates [9] and recall errors [5]. This research letter focuses on the practicability of collectinghealth care resource use data from general practitioner (GP)practices only, as this approach has been shown by some to bemore technically accurate [10]. The feasibility trial would seek tocapture any change in health care resource use following theintervention. Such knock-on data would be used to comparelevels of health care resource use over a set period of time, thatis, 6 months before and 6 months after rehabilitation betweenthose receiving the intervention and those not. Data would becollected retrospectively.The aims of this study were therefore to establish the dataroutinely collected by GPpractices, and how easily this data couldbe extracted for the feasibility trial.