1 of 12 Top Hip Papers of 2023 | Cost effectiveness of EDX for gluteal tendinopathy
Welcome to my 12 Top Hip Papers series of miniblogs from 2023, starting with this economical evaluation of the LEAP trial interventions for gluteal tendinopathy. Are 14 physio sessions for gluteal tendinopathy cost-effective?
Some of you might have joined me for my 12 Top Hip Papers of 2022 series last year - 12 papers from 2022 papers that contributed strongly to our understanding of hip conditions and/or the assessment or management of hip pain or injury. If you haven't already downloaded your free ebook of 12 top hip papers from 2022, you can do it by clicking HERE.
This year, I'll be focusing on helpful hip papers published in 2023. I am aiming to provide an overview of how the research has moved the hip space forward this year. I have prepared infographics and key learnings for each paper. Quick, but info-packed reads for this busy time of year.
For your convenience, we have also developed this content into a FREE 31-page full colour ebook!
Packed full of 12 Top Hip Papers - peer reviewed scientific papers from 2023, that have contributed to our understanding of hip conditions and/or the assessment or management of hip pain or injury.
Let's kick off day one then, with this paper that asked if an education & exercise intervention is cost-effective relative to 'wait-and-see' and corticosteroid injection for gluteal tendinopathy - a secondary analysis from the LEAP clinical trial.
1 of 12 Top Hip Papers of 2023 : The LEAP education and exercise program for gluteal tendinopathy improves quality-of-life and is cost effective1
Study Aim:
- This study aimed to determine the cost-effectiveness, both from a health system and societal perspective, of three management approaches for gluteal tendinopathy: education plus exercise, ultrasound-guided corticosteroid injection or wait and see.
What was done:
- An economic evaluation of interventions of a three-group, parallel, randomised clinical efficacy trial.
The economic evaluation was conducted using:
- Economic outcome measures:
- Quality-Adjusted Life Years (QALYs) calculated from EuroQol EQ-5D-3L, and
- Total economic costs obtained from participants over the 1-year follow-up period.
- Linear regression was used to estimate incremental QALYs and costs between interventions.
Key Findings:
-
An education & exercise intervention is cost-effective relative to both wait-and-see and corticosteroid injection for the management of gluteal tendinopathy.
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This is due to its superior health-related quality of life gains, despite slightly higher treatment costs.
Clinical Implications:
An intensive education and exercise program for gluteal tendinopathy, delivered over 8 weeks by a physiotherapist:
- is clinically superior (significantly higher success rates), and
- is likely to result in 'meaningful improvements in patients’ health-related quality of life and provide good value to the health system when compared with either a wait-and-see approach or corticosteroid injection.'
Despite the superior outcomes of the Education and Exercise Intervention for Gluteal Tendinopathy in the LEAP Randomised Clinical Trial, there were concerns in the health care professional community regarding the economic cost of 14 sessions with a physiotherapist.
This evaluation supports the LEAP education and exercise intervention for Gluteal Tendinopathy as both a clinically superior AND cost effective intervention, compared with CSI and a Wait-and-See approach. Good news for patients, physio's and funding bodies, and more evidence that a high-quality Education and Exercise intervention should be first-line management for Gluteal Tendinopathy.
Like to learn more about managing gluteal tendinopathy?
In this course, you can find detailed information on pathoaetiology, assessment and management of lateral hip pain associated with gluteal tendinopathy (greater trochanteric pain syndrome, trochanteric 'bursitis'), and many other conditions. To learn more, take the online course, or join me in a workshop.
This online course is included in Hip Academy and Hip Academy members receive discounts for online workshops.
If you have gluteal tendinopathy or trochanteric bursitis yourself (pain over the side of the hip), you can find my self-help course here: Recovering from Gluteal Tendinopathy, Trochanteric Bursitis and Greater Trochanteric Pain Syndrome
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