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Cost-effectiveness of yoga for managing musculoskeletal conditions in the workplace

Journal article
Authors N. Hartfiel
G. Clarke
Jonathan N. Havenhand
C. Phillips
R. T. Edwards
Published in Occupational Medicine
Volume 67
Issue 9
Pages 687-695
ISSN 0962-7480
Publication year 2017
Published at Department of marine sciences
Pages 687-695
Language en
Keywords Back pain, Cost-effectiveness, Musculoskeletal conditions, Occupational health, Physical activity, Randomized controlled trial, Return-on-investment, Sickness absence, Workplace, Yoga
Subject categories Environmental Health and Occupational Health


Background Back pain and musculoskeletal conditions negatively affect the health-related quality of life (HRQL) of employees and generate substantial costs to employers. Aims To assess the cost-effectiveness of yoga for managing musculoskeletal conditions. Methods A randomized controlled trial evaluated an 8-week yoga programme, with a 6-month follow-up, for National Health Service (NHS) employees. Effectiveness in managing musculoskeletal conditions was assessed using repeated-measures generalized linear modelling for the Roland-Morris Disability Questionnaire (RDQ) and the Keele STarT Back Screening Tool. Cost-effectiveness was determined using area-under-the-curve linear regression for assessing HRQL from healthcare and societal perspectives. The incremental cost per quality-adjusted life year (QALY) was also calculated. Sickness absence was measured using electronic staff records at 6 months. Results There were 151 participants. At 6 months, mean differences between groups favouring yoga were observed for RDQ [-0.63 (95% CI, -1.78, 0.48)], Keele STarT [-0.28 (95% CI, -0.97, 0.07)] and HRQL (0.016 QALY gain). From a healthcare perspective, yoga yielded an incremental cost-effectiveness ratio of £2103 per QALY. Given a willingness to pay for an additional QALY of £20 000, the probability of yoga being cost-effective was 95%. From a societal perspective, yoga was the dominant treatment compared with usual care. At 6 months, electronic staff records showed that yoga participants missed a total of 2 working days due to musculoskeletal conditions compared with 43 days for usual care participants. Conclusions Yoga for NHS employees may enhance HRQL, reduce disability associated with back pain, lower sickness absence due to musculoskeletal conditions and is likely to be cost-effective. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved.

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