Cost-effectiveness of Spinal Manipulative Therapy, Supervised Exercise, and Home Exercise for Older Adults with Chronic Neck Pain
Written by Editor   
Tuesday, January 10, 2017 11:27 AM

News Bite:  Here is yet another study that demonstrates that spinal manipulative therapy and home exercise provides superior results than home exercise alone, or supervised exercise and home exercise alone.

Chronic neck pain is a prevalent and disabling condition among older adults. Despite the large burden of neck pain, little is known regarding the cost-effectiveness of commonly used treatments.  This study aimed to estimate the cost-effectiveness of home exercise and advice (HEA), spinal manipulative therapy (SMT) plus HEA, and supervised rehabilitative exercise (SRE) plus HEA.

Cost-effectiveness analysis conducted alongside a randomized clinical trial (RCT) was performed, and total of 241 older adults (≥65 years) with chronic mechanical neck pain comprised the patient sample.

The outcome measures were direct and indirect costs, neck pain, neck disability, SF-6D-derived quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) over a 1-year time horizon.  Cost-effectivenesswas a secondary aim of the RCT.

Total costs for SMT+HEA were 5% lower than HEA and 47% lower than SRE+HEA. SMT+HEA also resulted in a greater reduction of neck pain over the year relative to HEA and SRE+HEA. Differences in disability and QALYs favored SMT+HEA.

On average, SMT+HEA resulted in better clinical outcomes and lower total societal costs relative to SRE+HEA and HEA alone.