BRIDGE Project: Multidisciplinary outpatient care program for patients, sick listed due to chronic low back pain. A randomised controlled trial and cost-effectiveness evaluation.
Background
Low back pain (LBP) is a major public and occupational health problem and associated with very high costs. The total annual cost of low back pain to Dutch society, is estimated to be € 4.6 billion per year. The economic burden of LBP is primarily related to indirect costs (93%) of productivity losses due to sick leave and long-term disability. The direct healthcare costs are much lower (7%). In general, the prognosis for RTW is good. However, approximately 10% to 25% of patients will have long-term absenteeism from work and will be at risk of social and financial deprivation. These patients account for 75% of the indirect costs of LBP.Research shows that work-related problems are associated with an increase in seeking medical care and sick leave. Usual care of medical specialists, general practitioners and allied health professionals of patients sick listed due to LBP is not directly aimed at RTW and co-operation with occupational physicians is usually poor. Besides the content of the usual care, also the limited information exchange between the treating and occupational physicians is often an obstacle for RTW. Because usual care of primary and outpatient health services isn’t directly aimed at RTW, it is desirable to look for care which is aimed at RTW.
Occupational interventions have proven to be (cost-)effective for return-to-work of low back pain patients in primary care, but the (cost-)effectiveness of these interventions has not yet been established for patients in a secondary care setting. To reduce sickleave and occupational disability of patients with LBP in secondary care, in this study multidisciplinary outpatient care, will be evaluated.