Chronic low back pain - KCE

108 Chronic low back pain KCE Reports vol.48
Table 18. Interval between first radiography of the lumbar spine and start of
treatment
Pain
treatment*
Physiotherapy Rehabilitation Surgery
N patients 19,226 10,221 7,644 1,680
Mean 38 83 77 117
Median 0 35 33 91
Minimum -30 0 0 0
Maximum 365 365 365 365
Percentiles 5 -25 1 0 8
10 -20 3 0 15
25 -8 10 8 34
75 44 132 116 176
90 168 250 237 268
95 251 305 298 317
* The negative counting for pain medication is explained by the medication delivered up to one month
before the first radiography
The duration of the treatments is illustrated in the appendix 2.5.10. The duration of
pharmacological treatment was estimated using the number of days between the first and
last delivery dates. It was assumed that one pack of pain medication lasted minimum one
week; therefore the minimum duration of treatment is 7 days. For the duration of
physiotherapy and rehabilitation the time between the first and the last date of medical act
was used.
82.0 % of the patients with chronic low back pain purchase at least one pack of
reimbursed pain medication. This percentage is significantly higher in patients over 60
than in the younger ones.
The duration of the pain therapy varies: 27.1% of the patients only purchase one pack of
reimbursed pain medication. On the other hand almost half (45.5%) of the patients who
bought at least one pack of pain medication go on with this medication for over 6 months.
Another, probably more accurate approach to calculate the duration of pharmacological
treatment is based on the Defined Daily Dose (DDD) which stands for the mean
maintenance dose of a drug used for its main indication in adults 342 . Table 19 illustrates
the distribution of the costs for the social security and of the DDD of pain medication
used by patients suffering chronic low back pain. The reimbursed pain medication costs
the health insurance 1.3 million. The mean cost is 68 for 102 DDD.