Methods: A population-based randomised controlled prevention trial, with recruitment through UK general practices. A mailed screening questionnaire identified adults at high risk of CWP. Participants received either usual care (UC) or a short course of telephone CBT. The primary outcome was CWP onset at 12 months assessed by mailed questionnaire. There were seven secondary outcomes including quality of life (EQ-5D-5L) used as part of a health economic assessment.
Results: 996 participants were randomised and included in the intention-to-treat analysis of which 825 provided primary outcome data. The median age of participants was 59 years; 59% were female. At 12 months there was no
difference in the onset of CWP (tCBT: 18.0% v. UC: 17.5%; OR 1.05; 95% CI 0.75-1.48). Participants who received tCBT were more likely to report better quality of life (EQ-5D-5L utility score mean difference 0.024 (95% CI 0.009-0.040));
and had 0.023 (95% CI 0.007-0.039) more QALYs at an additional cost of £42.30 (95% CI −451.19-597.90), yielding an incremental cost effectiveness ratio of £1,828. Most secondary outcomes showed significant benefit for the intervention.
Conclusions: A short course of tCBT does not prevent onset of CWP in adults at high risk, but did improve quality of life and was cost-effective. A low-cost, short duration, intervention benefits persons at risk of CWP.
|Journal||Annals of the Rheumatic Diseases|
|Publication status||Accepted/In press - 30 Nov 2020|