Cost-effectiveness of early interventions for non-specific low back pain: a randomized controlled study investigating medical yoga, exercise therapy and self-care advice.

OBJECTIVE: To evaluate the cost-effectiveness of medical yoga as an early intervention compared with evidence-based exercise therapy and self-care advice for non-specific low back pain. DESIGN: Randomized controlled trial with a cost-effectiveness analysis. SUBJECTS: A total of 159 participants randomized into the medical yoga group (n = 52), the exercise therapy group (n = 52) and the self-care advice group (n = 55). METHODS: The health outcome measure EQ-5D was applied to measure quality of life data combined with cost data collected from treatment groups from baseline to 12 months follow-up. Outcome measure was health-related quality of life (HRQL). Incremental cost per quality adjusted life year (QALY) was also calculated. Cost-effectiveness analysis was conducted primarily from the societal and employer perspectives. RESULTS: Medical yoga is cost-effective compared with self-care advice if an employer considers the significant improvement in the HRQL of an employee with low back pain justifies the additional cost of treatment (i.e. in this study EUR 150). From a societal perspective, medical yoga is a cost-effective treatment compared with exercise therapy and self-care advice if an additional QALY is worth EUR 11,500. Sensitivity analysis suggests that medical yoga is more cost-effective than its alternatives. CONCLUSION: Six weeks of uninterrupted medical yoga thera-py is a cost-effective early intervention for non-specific low back pain, when treatment recommendations are adhered to.

Promoting physical activity and healthy dietary behavior: the role of the occupational health services: a scoping review.

OBJECTIVE: Conduct a scoping review to identify and map the literature that has evaluated the effects of health promotion interventions aimed at physical activity and/or dietary behavior, implemented by the occupational health services. METHODS: A search for peer-reviewed articles was conducted (up to February 2013) through electronic databases, hand searching of key journals, and reference lists. A methodological quality assessment was performed. RESULTS: Fourteen studies were included, describing 10 interventions. The main component was counseling of individuals with known cardiovascular disease risk factors. Intervention effects were reported for dietary behavior, physical activity, sedentary behavior, and biological risk factors. CONCLUSIONS: Results are promising, especially with regard to interventions containing counseling targeting individuals at risk. High-quality studies using objective measures to assess behavioral outcomes and the (cost)-effectiveness of interventions containing counseling, PA on prescription, and multilevel interventions are needed.

Measuring production loss due to health and work environment problems: construct validity and implications.

OBJECTIVE: The aim was to validate two measures of production loss, health-related and work environment-related production loss, concerning their associations with health status and work environment factors. METHODS: Validity was assessed by evaluating the construct validity. Health problems related and work environment-related problems (or factors) were included in separate analyses and evaluated regarding the significant difference in proportion of explained variation (R) of production loss. RESULT: health problems production loss was not found to fulfill the criteria for convergent validity in this study; however, the measure of work environment-related production loss did fulfill the criteria that were set up. CONCLUSION: The measure of work environment-related production loss can be used to screen for production loss due to work environment problems as well as an outcome measure when evaluating the effect of organizational interventions.

The effects of psychosocial work factors on production loss, and the mediating effect of employee health.

OBJECTIVES: The aim of this study was to investigate whether there is a relationship between psychosocial work factors and production loss and whether a potential relationship is mediated by employee health. METHODS: A total of 2095 individuals from 4 different companies were included in this prospective study. Logistic regressions were performed to find psychosocial work factors of relevance for production loss, measured as sickness absence and presenteeism. RESULTS: Psychosocial work factors were significantly related to production loss. Health partly or fully mediated the relationship between psychosocial work factors and production loss. CONCLUSION: Several psychosocial work factors have both a direct and an indirect impact on companies' production loss. To be able to minimize production loss, companies must improve both psychosocial work factors and employees health.