Abstract
Background and purpose
The prevalence of back pain has remained relatively constant in the population in spite of previous interventions. Persons with sub-acute back pain are assumed to benefit from extended multidisciplinary, interdisciplinary or transdiciplinary and multisectorial, intersectorial or trans-sectorial interventions as an alternative to traditional mono-professional interventions. The purpose of this health technology assessment (HTA) was to document the possible effect of such interventions in patients suffering from back pain of 4-12 weeks duration.
Methods and results
A systematic literature review is the overall basis for this HTA and the analysis of the interventions in relation to technology, patients, organization, and economics. HTA reports, systematic reviews, and recent primary studies were included. Further, primary data from Danish institutions (public and private) with experience in working with this technology were collected. There is moderate evidence that early multidiciplnary, interdisciplinary and transdiciplinary interventions are more effective than monodiciplinary interventions or no interventions in primary care. The effects are mainly seen in relation to reduced sick leave at or beyond 12-months follow-up and not in relation to reduced pain or improved function. The interventions appear to be cost-effective. Danish back centers mainly use sequential and/or parallel collaborative models.
Conclusions
Extended multidisciplinary, interdisciplinary or transdiciplinary and multisectorial, intersectorial or trans-sectorial interventions delivered to patients with back pain of 4-12 weeks duration reduce sick-leave and appear to be cost-effective. The optimal content of such interventions cannot be determined but elements of cognitive behavioral therapy combined with graded exercise is used most frequently.
Conflict of interest: None
Sources of funding: This medical technology assessment was funded in full by the Danish Board of Health.
This HTA has been published as a report in Danish by the board of health in February 2010 but has not been presented at any scientific meetings or published in English in any journals
