Economic Evaluation of Early Physiotherapy Interventions for Osteoarthritis in Primary Care: Evidence

Abstract

Early physiotherapy intervention has been receiving more and more attention as a cost-effective and preventive measure of dealing with osteoarthritis, but is still under the economic scrutiny of evidence, especially in the initial stages of the disease development. A controlled and ethically viable research platform on the therapeutic and economic ramifications of early physiotherapy interventions can be gained through human-based research. This is a review of the evidence of rodent, rabbit, and canine models of osteoarthritis on the cost-effectiveness of primary care-based management systems using early physiotherapy. Consecutive findings indicate that early intervention of controlled mechanical loading, therapeutic exercise, and joint mobilization maintains cartilage integrity, lowers inflammation, enhances functional outcome, and prevents secondary musculoskeletal complications. Even though economic results are determined by surrogate measure indexes instead of calculating costs directly, cutting of rehabilitation time, intervention severity, the necessity of adjunctive measures and accumulative usage of resources are strong indicators of better cost efficiency. Automated and standardized physiotherapy systems also increase the efficacy of the treatment by optimizing resources used and lowering labor requirements. Although the biomechanics of species and the lack of realistic healthcare cost models restrict the direct clinical transfer, the reproducibility of results in human models of diseases contributes to early physiotherapy as the disease-modifying and cost-effective disease-saving strategy. All in all, human evidence presents a formidable rationale ground on which a preventive approach of using early physiotherapy interventions in managing osteoarthritis is a resource-saving measure.