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  • Principal Investigator: James Raftery
  • 1 April 2023 to 30 September 2023
  • Project No: 672
  • Funding round: FR6

Background
Pain from back, neck, hip or knee, and often at several sites, are the commonest causes of chronic pain. Treatments are limited. Improving self-management of chronic illness is a national priority.

Lessons in Alexander Technique (AT) aim to improve posture and whole body use to help sufferers better manage and prevent pain. An MRC study (ATEAM) found that for back pain AT was effective and good value for money (cost-effective) over 12 months. It also worked better at 12 months than 3 months. This suggests AT may be even better, and better value for money (cost-effective) in the longer term, but this was not assessed. Potential longer term benefits are important for patients, the health service and society. A full course of 24 1:1 AT lessons is also expensive. 1:1 lessons may also not help people learn from each other.

We have developed a course of lessons that include both 1:1 lessons and group lessons (the GREAT study). This was acceptable to patients and teachers. Disability in doing daily activities was also reduce by half. This suggests that the mixed course may work as well as a longer course of 1:1 lessons. Since the costs are less, the mixed course may be more cost effective than a full course of lessons.

We wish to develop a longer term cost-effectiveness model for AT using data from the ATEAM trial. This will help us explore the possible cost-effectiveness of the new course of lessons (from GREAT). This will help us make a much stronger case to argue for research funding to support the full development of a mixed course of 1:1 and group AT lessons.

Aim

To develop a longer term cost-effectiveness model for AT using data from the ATEAM trial.

The approach.

Developing the economic model.

We will

a) develop a longer term economic model beyond the timeframe of the original ATEAM trial using data from the ATEAM trial, and

b) use costs and data from the GREAT study to provide possible estimates for the cost-effectiveness of a mixed course of 1:1 and group lessons as an initial treatment.

Involving the public. 3 collaborators who have been involved with the GREAT study and its sister study for neck/hip/knee pain (GRACE) are contributing to this study. We also aim to recruit a wider PPI panel.

Sharing the findings.

We hope to be able to publish the long term model of the ATEAM data, in addition to presenting the results at conferences. Given the findings are by their nature exploratory wider dissemination of the GREAT economic analysis is probably not indicated.

Impact

The impact in the short term will be in bolstering the argument for a large PGfAR grant. In the longer term if the new course of lessons proves effective and cost-effective the main impact will be in providing benefit to patients for one of the commonest chronic conditions.

Amount awarded: £9,848

Projects by themes

We have grouped projects under the five SPCR themes in this document

Evidence synthesis working group

The collaboration will be conducting 18 high impact systematic reviews, under four workstreams.