Pain Exposure Physical Therapy versus conventional treatment in complex regional pain syndrome type 1-a cost-effectiveness analysis alongside a randomized controlled trial.

Fourteen patients received a different treatment than assigned before therapy began, and the paper also reports that 4 patients assigned to Pain Exposure Physical Therapy and 11 assigned to conventional treatment switched groups. Quality-of-life data were available for 42 patients, and cost data were available for 48 of 56 patients. The analysis did not include productivity losses or costs from time off work. Nine patients received medication or other conventional treatment, and the paper says this occurred among patients allocated to the intervention group. The conventional treatment followed Dutch national guidelines, so costs and treatment patterns may not match other countries. The primary clinical results were published elsewhere, so this paper does not present the full clinical effect estimates.

The Netherlands Organization for Health Research and Development funded the study, and the funder had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. The authors declared no potential conflicts of interest.

Do not read the lower cost as evidence that Pain Exposure Physical Therapy works better clinically. The trial found no significant difference in quality of life, and the clinical outcomes were not significantly different. Fourteen patients received a different treatment than assigned before therapy began, so the groups were not clean. The cost difference cannot be credited to one component because conventional care included medications and physical therapy.