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Factors associated with costs and health outcomes in patients with Back and leg pain in primary care: a prospective cohort analysis

Kigozi, Jesse; Konstantinou, Kika; Ogollah, Reuben; Dunn, Kate; Martyn, Lewis; Jowett, Susan


Jesse Kigozi

Kika Konstantinou

Associate Professor of Medical Statistics and Clinical Trials

Kate Dunn

Lewis Martyn

Susan Jowett


© 2019 The Author(s). Background: There is limited research on the economic burden of low back-related leg pain, including sciatica. The aim of this study was to describe healthcare resource utilisation and factors associated with cost and health outcomes in primary care patients consulting with symptoms of low back-related leg pain including sciatica. Methods: This study is a prospective cohort of 609 adults visiting their family doctor with low back-related leg pain, with or without sciatica in a United Kingdom (UK) Setting. Participants completed questionnaires, underwent clinical assessments, received an MRI scan, and were followed-up for 12-months. The economic analysis outcome was the quality-adjusted life year (QALY) calculated from the EQ-5D-3 L data obtained at baseline, 4 and 12-months. Costs were measured based on patient self-reported information on resource use due to back-related leg pain and results are presented from a UK National Health Service (NHS) and Societal perspective. Factors associated with costs and outcomes were obtained using a generalised linear model. Results: Base-case results showed improved health outcomes over 12-months for the whole cohort and slightly higher QALYs for patients in the sciatica group. NHS resource use was highest for physiotherapy and GP visits, and work-related productivity loss highest from a societal perspective. The sciatica group was associated with significantly higher work-related productivity costs. Cost was significantly associated with factors such as self-rated general health and care received as part of the study, while quality of life was significantly predicted by self-rated general health, and pain intensity, depression, and disability scores. Conclusions: Our results contribute to understanding the economics of low back- related leg pain and sciatica and may provide guidance for future actions on cost reduction and health care improvement strategies. Trial registration: 13/09/2011 Retrospectively registered; ISRCTN62880786.


Kigozi, J., Konstantinou, K., Ogollah, R., Dunn, K., Martyn, L., & Jowett, S. (2019). Factors associated with costs and health outcomes in patients with Back and leg pain in primary care: a prospective cohort analysis. BMC Health Services Research, 19, 1-9.

Journal Article Type Article
Acceptance Date Jun 13, 2019
Online Publication Date Jun 21, 2019
Publication Date Jun 21, 2019
Deposit Date Sep 5, 2019
Publicly Available Date Sep 5, 2019
Journal BMC Health Services Research
Electronic ISSN 1472-6963
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 19
Article Number 406
Pages 1-9
Keywords Cost, Outcome, Back pain, Leg pain, And sciatica
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