The objective of this paper was to determine the cost effectiveness of exercise therapy (intervention group) compared with " usual care" (control group) in adolescents and young adults with the patellofemoral pain syndrome in primary care. This multicenter prospective randomized clinical trial with cost-utility analysis was conducted at 38 general practices and three sport medical advice centers in the Netherlands for 2007. A total of 131 patients were included. The annual direct medical costs per patient were significantly higher for the intervention group (€434) compared with the control group (€299) mainly caused by additional physiotherapy visits. The average annual societal costs per patient were significantly lower in the intervention group (€1011 vs €1.166). Productivity costs were the largest cost component, in particular costs due to reduced efficiency at paid work which were responsible for 47% and 56% of the total costs in the intervention and control group respectively. Patients in the intervention group experienced a slightly, but not significantly, higher quality of life (0.8722 vs 0.8617). With a cost effectiveness ratio of -€14 738 per quality adjusted life year, exercise therapy appears to be cost effective as compared with " usual care."

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Scandinavian Journal of Medicine & Science in Sports
Erasmus MC: University Medical Center Rotterdam

Tan, S. S., van Linschoten, R., van Middelkoop, M., Koes, B., Bierma-Zeinstra, S., & Koopmanschap, M. (2010). Cost-utility of exercise therapy in adolescents and young adults suffering from the patellofemoral pain syndrome. Scandinavian Journal of Medicine & Science in Sports, 20(4), 568–579. doi:10.1111/j.1600-0838.2009.00980.x