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Cost Effectiveness of Arthrocentesis Compared to Conservative Therapy for Arthralgia of the Temporomandibular Joint
- Source :
- Journal of Oral & Facial Pain and Headache, 32(2), 198-207. Quintessence Publishing Co, Inc.
- Publication Year :
- 2018
- Publisher :
- Quintessence Publishing Co, Inc., 2018.
-
Abstract
- Aims: To determine the cost effectiveness and cost utility of arthrocentesis as an initial treatment for temporomandibular joint (TMJ) arthralgia compared to usual care. Methods: A two-armed, parallel-design, randomized controlled trial (RCT) was conducted in the Netherlands from January 2009 to June 2012 that included patients with TMJ arthralgia. Patients were randomly allocated to arthrocentesis (n = 40) or usual care (n = 40) for initial treatment. Arthrocentesis consisted of rinsing the intra-articular space with isotonic saline, and usual care included a soft diet, physical therapy, and splint therapy. The duration of the usual care program was 6 weeks, and follow-up was conducted 3, 12, and 26 weeks after its completion. Generalized estimated equation multivariate models were assessed in order to correct for the dependency of repeated measurements in the longitudinal data analysis. An independent samples t test was used to compare the arthrocentesis group with the usual care group for TMJ pain after 26 weeks. Cost effectiveness (total cost from a societal view) was related to TMJ pain (as measured on a visual analog scale [0 to 100 mm]) and to cost utility (quality-adjusted life years). Results: TMJ pain declined more quickly in the arthrocentesis group (n = 36) than in the usual care group (n = 36) (regression coefficient beta = -10.76; 95% confidence interval [CI] = -17.75 to -3.77; P = .003). The estimated mean total (ie, societal) cost over 26 weeks was (sic)589 (US $795) in the arthrocentesis group and (sic)1,680 (US $2,266) in the usual care group. Arthrocentesis was associated with a lower mean cost and better health outcomes than usual care in 98% and 95% of the bootstrap simulations, respectively. Conclusion: The results of this study suggest that, from an economical perspective, arthrocentesis may be superior to usual care for the initial treatment of TMJ pain, as it had better health outcomes and lower costs than usual care.
- Subjects :
- medicine.medical_specialty
Visual analogue scale
Cost effectiveness
DISORDERS
LAVAGE
medicine.medical_treatment
arthrocentesis
initial therapy
Health outcomes
RECOMMENDATIONS
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
stomatognathic system
law
medicine
Dentistry (miscellaneous)
arthralgia
DISPLACEMENT
LYSIS
cost effectiveness
business.industry
TMD
Arthrocentesis
PAIN
030206 dentistry
EUROQOL
Confidence interval
Temporomandibular joint
LIFE
Anesthesiology and Pain Medicine
medicine.anatomical_structure
030220 oncology & carcinogenesis
Cost utility
Physical therapy
TMJ CLOSED LOCK
Neurology (clinical)
business
RCT
Subjects
Details
- Language :
- English
- ISSN :
- 23330384
- Volume :
- 32
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Journal of Oral & Facial Pain and Headache
- Accession number :
- edsair.doi.dedup.....e0a6717c71a93571afcf525296efe6e4