RELATIONSHIP BETWEEN PAIN, FUNCTIONAL DISABILITY AND HEALTH-RELATED QUALITY OF LIFE IN PATIENT WITH FAILED BACK SURGERY SYNDROME UNDERGOING SPINAL CORD STIMULATION- RESULTS FROM THE PRECISE STUDY

Author(s)

Scalone L1, Zucco F2, Ciampichini R1, Lavano A3, Costantini A4, De Rose M3, Poli P5, Fortini G6, Demartini L7, De Simone E8, Menardo V9, Cisotto P10, Meglio M11, Mantovani LG1
1University of Milano - Bicocca, Monza, Italy, 2Azienda Ospedaliera Salvini, Garbagnate Milanese, Milano, Italy, 3Università degli Studi Magna Grecia, Germaneto, Italy, 4Ospedale Clinicizzato Ss.Annunziata, Chieti, Italy, 5Azienda Ospedaliera Universitaria Pisana, Pisa, Italy, 6AO Ospedale di Circolo e Fondazione Macchi di Varese, Varese, Italy, 7Istituto Scientifico di Pavia, Pavia, Italy, 8A.O.R.N. “S.G. Moscati, Avellino, Italy, 9AZIENDA OSPEDALIERA S. CROCE E CARLE, Cuneo, Italy, 10Ospedale S. Maria di Cà Foncello, Treviso, Italy, 11Policlinico Universitario, Roma, Italy

OBJECTIVES: Failed back surgery syndrome (FBSS) represents one main cause of chronic neuropathic or mixed pain and functional disability. Results from previous clinical trials and from the PRECISE naturalistic study [Zucco et al, Neuromodulation, 2015] show that Spinal Cord Stimulation (SCS) provides pain relief and improves patients’ health. Our current aim is to understand the relationship between pain intensity, functional disability, and overall Health-Related Quality-of-life (HRQoL). METHODS: At recruitment (before SCS) and every 6 months for 2 years after SCS a battery of questionnaires/tests were completed: EQ-5D-3L and SF-36 for HRQoL, the Numerical Rating Scale (NRS) to measure pain intensity, and the Oswestry Disability Index (ODI) to measure disability/functional capability. Statistical tests were conducted to compare the HRQoL levels (using the EQ-5D utility index, the EQ-VAS, the SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) index), NRS and ODI at baseline with those measured during the observational period. Multilevel regression analyses were conducted to investigate the association between the HRQOL indexes and the NRS and ODI indexes, on adjusting for: age, gender, previous surgery, education, baseline level of the dependent variable, and time of assessment. RESULTS: Eighty patients (40% male, mean age=58 years) participated. Significant improvements (p<0.001) in pain intensity, functional capability and HRQoL were reached after 6 months from SCS and maintained or further improved until the end of the observational period. According to the regression models, every HRQoL index was significantly associated (p<0.001) with both the NRS and the ODI indexes at any time of assessment. CONCLUSIONS: Our results suggest that in a 2-year observational period, SCS+CMM treatment reduces significantly pain intensity and functional disability in patients with FBSS, with significant repercussions on their general HRQOL. Furthermore, our results suggest the HRQoL instruments used in this study are valid to assess overall patients’ health and treatment outcomes.

Conference/Value in Health Info

2015-11, ISPOR Europe 2015, Milan, Italy

Value in Health, Vol. 18, No. 7 (November 2015)

Code

PMS78

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Musculoskeletal Disorders, Systemic Disorders/Conditions

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