4.3 Article

Economic Evaluation of an Extended Telehealth Worksite Exercise Intervention to Reduce Lost Work Time from Low Back Pain in Career Firefighters

Journal

JOURNAL OF OCCUPATIONAL REHABILITATION
Volume 31, Issue 2, Pages 431-443

Publisher

SPRINGER/PLENUM PUBLISHERS
DOI: 10.1007/s10926-020-09933-8

Keywords

Exercise; Firefighters; Low back pain; Lost work time; Economic evaluation

Funding

  1. Federal Emergency Management Agency, U.S. Department of Homeland Security [EMW-2013-FP-00723]

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Worksite exercise was found to reduce lost work time due to low back pain in firefighters. Telehealth was less costly and more effective at reducing lost work time due to low back pain compared to direct exercise supervision. Further reduction in the costs of telehealth could potentially lead to a positive net monetary benefit compared to no intervention.
Purpose Low back pain (LBP) is a leading cause of lost work time (LWT) in firefighters and is related to poor muscle endurance. Although exercise can improve muscle endurance, it must be continued to sustain benefits, and it is unknown if it can reduce LWT. This study conducted an economic evaluation of an extended worksite exercise intervention in career firefighters. Methods A randomized controlled trial allocated 264 firefighters to telehealth with remote instruction (telehealth), direct exercise supervision (direct), or brief education (control). The telehealth and direct groups performed worksite exercises twice weekly for 12 months. Outcomes included quality adjusted life years, LWT from LBP (24-h shifts), costs of LWT from LBP, and net monetary benefits. Results A total of 216 firefighters were included in the economic analysis (telehealth n = 71, direct n = 75, control n = 70). Sixteen experienced LWT from LBP (telehealth n = 4, direct n = 4, control n = 8). The mean number of 24-h shifts lost from LBP were 0.05 (telehealth), 0.28 (direct), and 0.43 (control). Mean study intervention costs per participant were $1984 (telehealth), $5269 (direct), and $384 (control). Net monetary benefit was $3573 for telehealth vs. direct, - $1113 for telehealth vs. control, and - $4686 for direct vs. control. Conclusions Worksite exercise reduced LWT from LBP in firefighters. Telehealth was less costly and more effective at reducing LWT from LBP than direct exercise supervision. If the costs of telehealth were further reduced, a positive net monetary benefit might also be achieved when compared to no intervention.

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