Clinical and economic burden of low back pain in low- and middle-income countries: a systematic review

Francis Fatoye; Tadesse Gebrye; Chidozie Emmanuel Mbada; Ushotanefe Useh

doi:10.1136/bmjopen-2022-064119

Clinical and economic burden of low back pain in low- and middle-income countries: a systematic review

BMJ Open. 2023 Apr 25;13(4):e064119. doi: 10.1136/bmjopen-2022-064119.

Authors

Francis Fatoye¹, Tadesse Gebrye², Chidozie Emmanuel Mbada³, Ushotanefe Useh⁴

Affiliations

¹ Department of Health Professions, Manchester Metropolitan University, Manchester, UK t.gebrye@mmu.ac.uk.
² Department of Health Professions, Manchester Metropolitan University, Manchester, UK.
³ Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria.
⁴ Lifestyle Diseases, Faculty of Health Sciences, North West University, Mmabatho, South Africa.

Abstract

Objectives: Low back pain (LBP) is the leading cause of disability and work absenteeism globally, and it poses significant clinical and economic burden to individuals, health systems and the society. This study aimed to synthesise the clinical and economic burden of LBP in low-income and middle-income countries (LMICs).

Methods: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. PubMed, Medline, CINAHL, PsycINFO, AMED, Embase and Scopus databases were systematically searched for studies that examined the clinical and economic burden of LBP in LMICs, published from inception to 10 December 2021. Only studies with clearly stated methodologies and published in English were eligible for review.

Results: Nine studies met the inclusion criteria and were reviewed. Of these, three of them were clinical burden studies. The mean Newcastle-Ottawa Quality Assessment Scale (NOS) score of the included studies was 4, with an average from 3 to 6. The included studies were conducted in Argentina, Brazil, China, Ethiopia, Nigeria and Republic of Serbia. The rates of hospitalisation due to LBP ranged between 13.4% and 18.7%. Due to variation of methodological approaches, the reported cost estimates were inconsistent across the studies. A total cost of US$2.2 billion per population and US$1226.25 per patient were reported annually due to LBP.

Conclusion: This systematic literature review suggests that LBP is associated with significantly high rates of hospitalisation and costs. As LBP is an important threat to the population, health professionals and policymakers are to put in place appropriate programmes to reduce the clinical and economic burden associated with LBP and improve the health outcomes of individuals with this condition in LMICs.

Prospero registration number: CRD42020196335.

Keywords: Back pain; Health economics; PAIN MANAGEMENT; Spine.

Publication types

Systematic Review

MeSH terms

Argentina
Brazil
Developing Countries
Financial Stress
Humans
Low Back Pain* / epidemiology
Low Back Pain* / etiology
Low Back Pain* / therapy