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Shahabi S1, Nazari B1, Fathi B2, Hosseinabadi M1
1Iran University of Medical Science, Tehran, Iran, 2Tabriz University of Medical Sciences, Tabriz, Iran
Background: Lower Limb osteoarthritis (OA) is a major public health issue because it causes chronic pain, reduces physical function and diminishes the quality of life. Aging of the population is anticipated to increase the prevalence of hip, knee, and ankle OA and their associated impairments. Physiotherapy interventions are consistently recommended for older adults with lower limb pain related to osteoarthritis. There are several different costs associated with the development and implementation of these interventions. According to the need for health policymakers to choose the most cost-effective approach, this systematic review study was conducted.
Purpose: The objective of this study was to evaluate the economic evaluation (cost-effectiveness analysis, cost-benefit analysis, and cost-utility) of physiotherapy interventions for lower limb OA in elderly.
Methods: Electronic databases were searched (from March 2008 to March 2018): EMBASE, PubMed, MEDLINE, CINAHL, AMED, the Cochrane Central Register of Controlled Trials (CENTRAL), the Global Health Library, Physiotherapy Evidence Database (PEDro). We also screened the reference lists of the included studies and identified systematic reviews. The search was combined various terms for each concept and was include both free text-words and controlled vocabulary terms (such as MeSH (Medical Subject Headings)). Two reviewers completed a full-text screening of studies identified as being potentially relevant, in duplicate and independently (S.SH and M.H). Any disagreements will be resolved through discussion between the reviewers (S.SH, M.H, and B.F). Risk of bias for each included study be assessed independently by two authors (S.SH and B.F). We used the Cochrane risk of bias tool to assess randomized studies. In the initial search, 48 studies were found, and then 11 studies were selected for careful review.
Results: Nine economic evaluations and two randomized controlled trials reporting health-related costs met our inclusion criteria. Interventions included exercises, manual therapy, and rehabilitation programs. Six of the 11 studies exhibited high risks of bias for the cost and effect components. Six studies reported cost-effectiveness estimates lower than $30000 per QALY (Quality-Adjusted Life Years). All studies expressed that exercise interventions be cost saving.
Conclusion(s): There is limited evidence for the economic evaluation of conservative treatments for the management of lower limb osteoarthritis. So, more high-quality economic evaluations of conservative interventions are needed to further inform practice.
Implications: Inform health policymakers about the benefits of rehabilitation interventions
Keywords: Economic Evaluation, Physiotherapy, Osteoarthritis, Aging, Systematic Review
Funding acknowledgements: Without funding
Purpose: The objective of this study was to evaluate the economic evaluation (cost-effectiveness analysis, cost-benefit analysis, and cost-utility) of physiotherapy interventions for lower limb OA in elderly.
Methods: Electronic databases were searched (from March 2008 to March 2018): EMBASE, PubMed, MEDLINE, CINAHL, AMED, the Cochrane Central Register of Controlled Trials (CENTRAL), the Global Health Library, Physiotherapy Evidence Database (PEDro). We also screened the reference lists of the included studies and identified systematic reviews. The search was combined various terms for each concept and was include both free text-words and controlled vocabulary terms (such as MeSH (Medical Subject Headings)). Two reviewers completed a full-text screening of studies identified as being potentially relevant, in duplicate and independently (S.SH and M.H). Any disagreements will be resolved through discussion between the reviewers (S.SH, M.H, and B.F). Risk of bias for each included study be assessed independently by two authors (S.SH and B.F). We used the Cochrane risk of bias tool to assess randomized studies. In the initial search, 48 studies were found, and then 11 studies were selected for careful review.
Results: Nine economic evaluations and two randomized controlled trials reporting health-related costs met our inclusion criteria. Interventions included exercises, manual therapy, and rehabilitation programs. Six of the 11 studies exhibited high risks of bias for the cost and effect components. Six studies reported cost-effectiveness estimates lower than $30000 per QALY (Quality-Adjusted Life Years). All studies expressed that exercise interventions be cost saving.
Conclusion(s): There is limited evidence for the economic evaluation of conservative treatments for the management of lower limb osteoarthritis. So, more high-quality economic evaluations of conservative interventions are needed to further inform practice.
Implications: Inform health policymakers about the benefits of rehabilitation interventions
Keywords: Economic Evaluation, Physiotherapy, Osteoarthritis, Aging, Systematic Review
Funding acknowledgements: Without funding
Topic: Older people; Service delivery/emerging roles; Musculoskeletal: lower limb
Ethics approval required: No
Institution: Iran University of Medical Sciences
Ethics committee: Research Ethics Committee of the Iran University of Medical Sciences
Reason not required: because of systematic review
All authors, affiliations and abstracts have been published as submitted.
