Economic evaluation of a lifestyle intervention for individuals with overweight or obesity suffering from chronic low back pain (the BO2WL trial): a protocol for a health economic analysis

Alexander Schurz; Tom Deliens; Melanie Liechti; Matteo Vanroose; Ron Clijsen; Jo Nijs; Anneleen Malfliet; Wouter Van Bogaert; Peter Clarys; Heiner Baur; Jan Taeymans; Nathanael Lutz

doi:10.1136/ bmjopen-2024-098272

Economic evaluation of a lifestyle intervention for individuals with overweight or obesity suffering from chronic low back pain (the BO2WL trial): a protocol for a health economic analysis

Alexander Schurz, Tom Deliens, Melanie Liechti, Matteo Vanroose, Ron Clijsen, Jo Nijs, Anneleen Malfliet, Wouter Van Bogaert, Peter Clarys, Heiner Baur, Jan Taeymans, Nathanael Lutz

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction Low back pain (LBP) is highly prevalent across the Western world, including Switzerland (CH) and Belgium (BE), with women experiencing higher disability rates than men. Chronic LBP (CLBP), persisting beyond 3 months, leads to diminished health-related quality of life and increased healthcare and societal costs. Evidence indicates a direct relationship between body mass index (BMI) and CLBP severity, with high BMI significantly driving LBP-related healthcare expenses. Current evidence supports combining pain neuroscience education (PNE) with cognition-targeted exercise therapy (CTET) to effectively manage CLBP. An economic evaluation alongside a randomised controlled trial, entitled ‘Lifestyle Intervention in Overweight/Obese CLBP Patients: an International Multi-centre RCT’ (BO2WL), will be conducted in CH and BE. It aims to evaluate the addition of a lifestyle intervention to PNE and CTET compared with PNE and CTET alone for treating individuals
with CLBP and overweight or obesity. This protocol outlines the details of the economic evaluation of this trial. Methods and analysis The trial consists of a 14-week intervention followed by a 52-week post-intervention follow-up. Primary outcomes include direct and indirect costs, as well as quality-adjusted life years and pain intensity. Cost data will be converted into 2026 Belgium € (BE) and 2026 Swiss Francs (CHF) for CH, with a discount rate of 3.5%. Incremental cost-utility and cost-effectiveness ratios will be calculated from a societal perspective for each country.
Ethics and dissemination Ethics approval was obtained by the local ethics committees (Bern, CH: project ID 2022–02210; Brussels and Geel, BE: BUN 1432022000296).
Results of the main trial and economic evaluation will be submitted for publication in a peer-reviewed journal.
Trial registration number NCT05811624.

Original language	English
Article number	15
Pages (from-to)	1-9
Number of pages	9
Journal	BMJ Open
Volume	15
Issue number	e098272
DOIs	https://doi.org/10.1136/ bmjopen-2024-098272
Publication status	Published - 20 Jun 2025

Keywords

Health economic analysis plan

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10.1136/ bmjopen-2024-098272Licence: CC BY-NC-SA

FWOAL1055: Weight Loss Intervention in Overweight/Obese People Suffering from Chronic Low Back Pain: an International Multi-center Randomized Controlled Trial (WEAVE)
Nijs, J., Clarys, P. & Deliens, T.
1/01/22 → 31/12/25
Project: Fundamental

Cite this

Schurz, A., Deliens, T., Liechti, M., Vanroose, M., Clijsen, R., Nijs, J., Malfliet, A., Van Bogaert, W., Clarys, P., Baur, H., Taeymans, J., & Lutz, N. (2025). Economic evaluation of a lifestyle intervention for individuals with overweight or obesity suffering from chronic low back pain (the BO2WL trial): a protocol for a health economic analysis. BMJ Open, 15(e098272), 1-9. Article 15. https://doi.org/10.1136/ bmjopen-2024-098272

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abstract = "Introduction Low back pain (LBP) is highly prevalent across the Western world, including Switzerland (CH) and Belgium (BE), with women experiencing higher disability rates than men. Chronic LBP (CLBP), persisting beyond 3 months, leads to diminished health-related quality of life and increased healthcare and societal costs. Evidence indicates a direct relationship between body mass index (BMI) and CLBP severity, with high BMI significantly driving LBP-related healthcare expenses. Current evidence supports combining pain neuroscience education (PNE) with cognition-targeted exercise therapy (CTET) to effectively manage CLBP. An economic evaluation alongside a randomised controlled trial, entitled {\textquoteleft}Lifestyle Intervention in Overweight/Obese CLBP Patients: an International Multi-centre RCT{\textquoteright} (BO2WL), will be conducted in CH and BE. It aims to evaluate the addition of a lifestyle intervention to PNE and CTET compared with PNE and CTET alone for treating individualswith CLBP and overweight or obesity. This protocol outlines the details of the economic evaluation of this trial. Methods and analysis The trial consists of a 14-week intervention followed by a 52-week post-intervention follow-up. Primary outcomes include direct and indirect costs, as well as quality-adjusted life years and pain intensity. Cost data will be converted into 2026 Belgium € (BE) and 2026 Swiss Francs (CHF) for CH, with a discount rate of 3.5%. Incremental cost-utility and cost-effectiveness ratios will be calculated from a societal perspective for each country.Ethics and dissemination Ethics approval was obtained by the local ethics committees (Bern, CH: project ID 2022–02210; Brussels and Geel, BE: BUN 1432022000296).Results of the main trial and economic evaluation will be submitted for publication in a peer-reviewed journal.Trial registration number NCT05811624.",

keywords = "Health economic analysis plan",

author = "Alexander Schurz and Tom Deliens and Melanie Liechti and Matteo Vanroose and Ron Clijsen and Jo Nijs and Anneleen Malfliet and {Van Bogaert}, Wouter and Peter Clarys and Heiner Baur and Jan Taeymans and Nathanael Lutz",

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Schurz, A , Deliens, T , Liechti, M , Vanroose, M , Clijsen, R , Nijs, J , Malfliet, A , Van Bogaert, W , Clarys, P, Baur, H, Taeymans, J & Lutz, N 2025, 'Economic evaluation of a lifestyle intervention for individuals with overweight or obesity suffering from chronic low back pain (the BO2WL trial): a protocol for a health economic analysis', BMJ Open, vol. 15, no. e098272, 15, pp. 1-9. https://doi.org/10.1136/ bmjopen-2024-098272

Economic evaluation of a lifestyle intervention for individuals with overweight or obesity suffering from chronic low back pain (the BO2WL trial): a protocol for a health economic analysis. / Schurz, Alexander ; Deliens, Tom ; Liechti, Melanie et al.
In: BMJ Open, Vol. 15, No. e098272, 15, 20.06.2025, p. 1-9.

Research output: Contribution to journal › Article › peer-review

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T1 - Economic evaluation of a lifestyle intervention for individuals with overweight or obesity suffering from chronic low back pain (the BO2WL trial): a protocol for a health economic analysis

AU - Schurz, Alexander

AU - Deliens, Tom

AU - Liechti, Melanie

AU - Vanroose, Matteo

AU - Clijsen, Ron

AU - Nijs, Jo

AU - Malfliet, Anneleen

AU - Van Bogaert, Wouter

AU - Clarys, Peter

AU - Baur, Heiner

AU - Taeymans, Jan

AU - Lutz, Nathanael

PY - 2025/6/20

Y1 - 2025/6/20

N2 - Introduction Low back pain (LBP) is highly prevalent across the Western world, including Switzerland (CH) and Belgium (BE), with women experiencing higher disability rates than men. Chronic LBP (CLBP), persisting beyond 3 months, leads to diminished health-related quality of life and increased healthcare and societal costs. Evidence indicates a direct relationship between body mass index (BMI) and CLBP severity, with high BMI significantly driving LBP-related healthcare expenses. Current evidence supports combining pain neuroscience education (PNE) with cognition-targeted exercise therapy (CTET) to effectively manage CLBP. An economic evaluation alongside a randomised controlled trial, entitled ‘Lifestyle Intervention in Overweight/Obese CLBP Patients: an International Multi-centre RCT’ (BO2WL), will be conducted in CH and BE. It aims to evaluate the addition of a lifestyle intervention to PNE and CTET compared with PNE and CTET alone for treating individualswith CLBP and overweight or obesity. This protocol outlines the details of the economic evaluation of this trial. Methods and analysis The trial consists of a 14-week intervention followed by a 52-week post-intervention follow-up. Primary outcomes include direct and indirect costs, as well as quality-adjusted life years and pain intensity. Cost data will be converted into 2026 Belgium € (BE) and 2026 Swiss Francs (CHF) for CH, with a discount rate of 3.5%. Incremental cost-utility and cost-effectiveness ratios will be calculated from a societal perspective for each country.Ethics and dissemination Ethics approval was obtained by the local ethics committees (Bern, CH: project ID 2022–02210; Brussels and Geel, BE: BUN 1432022000296).Results of the main trial and economic evaluation will be submitted for publication in a peer-reviewed journal.Trial registration number NCT05811624.

AB - Introduction Low back pain (LBP) is highly prevalent across the Western world, including Switzerland (CH) and Belgium (BE), with women experiencing higher disability rates than men. Chronic LBP (CLBP), persisting beyond 3 months, leads to diminished health-related quality of life and increased healthcare and societal costs. Evidence indicates a direct relationship between body mass index (BMI) and CLBP severity, with high BMI significantly driving LBP-related healthcare expenses. Current evidence supports combining pain neuroscience education (PNE) with cognition-targeted exercise therapy (CTET) to effectively manage CLBP. An economic evaluation alongside a randomised controlled trial, entitled ‘Lifestyle Intervention in Overweight/Obese CLBP Patients: an International Multi-centre RCT’ (BO2WL), will be conducted in CH and BE. It aims to evaluate the addition of a lifestyle intervention to PNE and CTET compared with PNE and CTET alone for treating individualswith CLBP and overweight or obesity. This protocol outlines the details of the economic evaluation of this trial. Methods and analysis The trial consists of a 14-week intervention followed by a 52-week post-intervention follow-up. Primary outcomes include direct and indirect costs, as well as quality-adjusted life years and pain intensity. Cost data will be converted into 2026 Belgium € (BE) and 2026 Swiss Francs (CHF) for CH, with a discount rate of 3.5%. Incremental cost-utility and cost-effectiveness ratios will be calculated from a societal perspective for each country.Ethics and dissemination Ethics approval was obtained by the local ethics committees (Bern, CH: project ID 2022–02210; Brussels and Geel, BE: BUN 1432022000296).Results of the main trial and economic evaluation will be submitted for publication in a peer-reviewed journal.Trial registration number NCT05811624.

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DO - 10.1136/ bmjopen-2024-098272

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SN - 2044-6055

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JO - BMJ Open

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IS - e098272

M1 - 15

ER -

Economic evaluation of a lifestyle intervention for individuals with overweight or obesity suffering from chronic low back pain (the BO2WL trial): a protocol for a health economic analysis

Abstract

Keywords

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Projects

FWOAL1055: Weight Loss Intervention in Overweight/Obese People Suffering from Chronic Low Back Pain: an International Multi-center Randomized Controlled Trial (WEAVE)

Cite this