Dr. Brona Fullen:

I will respond to what has been asked about absenteeism from work. Dr. Maguire’s study from NUIG showed that by managing patients earlier in the process one can get them back to work. The study was on patients with back pain, which is the most prevalent condition that manifests in pain clinics and that maps to the international literature. The approach used was to target patients specifically with regards to their disability, lack of movement and fear of movement – a lot of patients with back pain are afraid to move in case they make the problem worse - thus educating patients around the benefits of exercise both from a physical point of view and a psychological point of view as that will promote early return to work. That was shown in the study in Galway.

In terms of the cost-benefit analysis, they are doing a health economic evaluation of the study that was done that showed that compared to a control group of patients, of patients who underwent early intervention at six months 20% of them were back to work compared to 12% of patients who were managed based on ordinary standards of care. I could ask Dr. Maguire to forward the health economics paper when it is available. Anecdotally, there are significant cost benefits and getting patients back to work will eventually cost the State less. We need to target patients physically and psychologically but the success rate is high if one does that. Again, that maps with international findings.