Health-economic Evaluation of Interventional Pain Management Compared to Pain Rehabilitation
Condition: Chronic Pain
MeSH terms: Chronic Pain
Study type: Observational [Patient Registry]

Summary: 
      The overall aim of the study is to evaluate interventional pain management. This is done in
      three steps:

        1. To find matched controls to the patients in the study on cost-effectiveness of IPM and
           compare the results.

        2. To calculate cost-effectiveness of PRP during the period 2010-2016, on a national level.

        3. To calculate cost-effectiveness of PRP during the period 2017-2019, after the changed
           guidelines for PRP in Sweden.

      The two last steps are to provide a background to the results of IPM, and to see if the
      results in the subgroup of matched controls of PRP-patients differ from the results from the
      whole population.
    

Detailed description: 
      Chronic pain is one of the major health problems globally, according to the WHO 'global
      burden of disease' studies. Previously, the investigators have performed a study on a
      feasible approach to be able to treat zygapophyseal joint pain in the thoracic region,
      similar to the established methods for treatment in the lumbar and cervical regions which
      have been published. The study showed that there was a significant improvement in health
      related quality of life (HRQoL) after treatment, and that there were no difference in the
      results depending on if it was the cervical, thoracic or lumbar region that was treated. The
      study had ethical approval (Dnr 2012-446-31M) and is registered here at clinicaltrials.gov.

      Another study explored the health economic aspects of interventional pain management (IPM).
      The investigators aimed to do this in comparison with pain rehabilitation programs, and
      therefore further ethical approval was searched and gained (2012-446-31M, 2017-542-32, 2018-
      507-32) An health-economic evaluation of only IPM was performed showing that patients after
      treatment of diagnosed pain-focuses in zygapophyseal joint pain not only improve their HRQoL
      but they also reduce their medication, reduced their health-care consumption and gained in
      ability to work. The cost per quality adjusted life years gained was below the threshold for
      cost-effective health-care according to the threshold-levels defined by the national Board of
      Health and Welfare in Sweden. But the investigators need a larger population to select from
      in order to get matched controls among patients that have been through pain rehabilitation
      programs.

      This study therefore aims to explore the national register of pain rehabilitation both in
      order to find matched controls and in order to make a cost-effectiveness study of pain
      rehabilitation program as it is performed in Sweden.
    

Intervention name(s): Pain rehabilitation program
Intervention type(s): Other
Intervention description(s): Effect on health related quality of life och health-care consumption after rehabilitation
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients that have been treated with pain rehabilitation programs and that have been
        registered prospectively in the national register for pain rehabilitation in Sweden