Purpose: Previous studies found higher levels of pain severity and disability to be associated with higher costs and lower health-related quality of life. However, these findings were based on cross-sectional data and little is known about the longitudinal relationships between pain severity and disability versus health-related quality of life and costs among chronic low back pain patients. This study aims to cover this knowledge gap by exploring these longitudinal relationships in a consecutive cohort. Methods: Data of 6316 chronic low back pain patients were used. Measurements took place at 3, 6, 9, and 12 months. Pain severity (Numeric pain rating scale; range: 0–100), disability (Oswestry disability index; range: 0–100), health-related quality of life (EQ-5D-3L: range: 0–1), societal and healthcare costs (cost questionnaire) were measured. Using linear generalized estimating equation analyses, longitudinal relationships were explored between: (1) pain severity and health-related quality of life, (2) disability and health-related quality of life, (3) pain severity and societal costs, (4) disability and societal costs, (5) pain severity and healthcare costs, and (6) disability and healthcare costs. Results: Higher pain and disability levels were statistically significantly related with poorer health-related quality of life (pain intensity: − 0.0041; 95% CI − 0.0043 to − 0.0039; disability: − 0.0096; 95% CI − 0.0099 to − 0.0093), higher societal costs (pain intensity: 7; 95% CI 5 to 8; disability: 23; 95% CI 20 to 27) and higher healthcare costs (pain intensity: 3; 95% CI 2 to 4; disability: 9; 95% CI 7 to 11). Conclusion: Pain and disability were longitudinally related to health-related quality of life, societal costs, and healthcare costs. Disability had a stronger association with all outcomes compared to pain.

Additional Metadata
Keywords Disability, Health-related quality of life, Longitudinal analysis, Low back pain, Pain, Societal costs
Persistent URL dx.doi.org/10.1007/s11136-019-02302-w, hdl.handle.net/1765/120655
Journal Quality of Life Research
Citation
Mutubuki, E.N. (E. N.), Beljon, Y. (Y.), Maas, E.T, Huygen, F.J.P.M, Ostelo, R.W.J.G, van Tulder, M.W, & van Dongen, J.M. (J. M.). (2019). The longitudinal relationships between pain severity and disability versus health-related quality of life and costs among chronic low back pain patients. Quality of Life Research. doi:10.1007/s11136-019-02302-w