caa a22 4500 445831928 CHVBK 20180317145318.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s00586-010-1675-4 doi (NATIONALLICENCE)springer-10.1007/s00586-010-1675-4 Cost-effectiveness of general practice care for low back pain: a systematic review [Elektronische Daten] [Chung-Wei Lin, Marion Haas, Chris Maher, Luciana Machado, Maurits van Tulder] Care from a general practitioner (GP) is one of the most frequently utilised healthcare services for people with low back pain and only a small proportion of those with low back pain who seek care from a GP are referred to other services. The aim of this systematic review was to evaluate the evidence on cost-effectiveness of GP care in non-specific low back pain. We searched clinical and economic electronic databases, and the reference list of relevant systematic reviews and included studies to June 2010. Economic evaluations conducted alongside randomised controlled trials with at least one GP care arm were eligible for inclusion. Two reviewers independently screened search results and extracted data. Eleven studies were included; the majority of which conducted a cost-effectiveness or cost-utility analysis. Most studies investigated the cost-effectiveness of usual GP care. Adding advice, education and exercise, or exercise and behavioural counselling, to usual GP care was more cost-effective than usual GP care alone. Clinical rehabilitation and/or occupational intervention, and acupuncture were more cost-effective than usual GP care. One study investigated the cost-effectiveness of guideline-based GP care, and found that adding exercise and/or spinal manipulation was more cost-effective than guideline-based GP care alone. In conclusion, GP care alone did not appear to be the most cost-effective treatment option for low back pain. GPs can improve the cost-effectiveness of their treatment by referring their patients for additional services, such as advice and exercise, or by providing the services themselves. The Author(s), 2011 Low back pain nationallicence Cost-effectiveness analysis nationallicence Primary health care nationallicence Systematic review nationallicence Lin Chung-Wei The George Institute for Global Health and Sydney Medical School, The University of Sydney, Missenden Rd, PO Box M201, 2050, Sydney, NSW, Australia aut Haas Marion Centre for Health Economics Research and Evaluation, The University of Technology, PO Box 123, 2007, Sydney, Broadway, Australia aut Maher Chris The George Institute for Global Health and Sydney Medical School, The University of Sydney, Missenden Rd, PO Box M201, 2050, Sydney, NSW, Australia aut Machado Luciana Departamento de Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Av Antônio Carlos 6627, Pampulha, 31270-901, Belo Horizonte, MG, Brazil aut van Tulder Maurits Department of Health Sciences, Faculty of Earth and Life Sciences, The EMGO Institute for Health and Care Research, VU University, de Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands aut European Spine Journal Springer-Verlag 20/7(2011-07-01), 1012-1023 0940-6719 20:7<1012 2011 20 586 https://doi.org/10.1007/s00586-010-1675-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-010-1675-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lin Chung-Wei The George Institute for Global Health and Sydney Medical School, The University of Sydney, Missenden Rd, PO Box M201, 2050, Sydney, NSW, Australia aut NATIONALLICENCE 700 1- Haas Marion Centre for Health Economics Research and Evaluation, The University of Technology, PO Box 123, 2007, Sydney, Broadway, Australia aut NATIONALLICENCE 700 1- Maher Chris The George Institute for Global Health and Sydney Medical School, The University of Sydney, Missenden Rd, PO Box M201, 2050, Sydney, NSW, Australia aut NATIONALLICENCE 700 1- Machado Luciana Departamento de Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Av Antônio Carlos 6627, Pampulha, 31270-901, Belo Horizonte, MG, Brazil aut NATIONALLICENCE 700 1- van Tulder Maurits Department of Health Sciences, Faculty of Earth and Life Sciences, The EMGO Institute for Health and Care Research, VU University, de Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/7(2011-07-01), 1012-1023 0940-6719 20:7<1012 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer