Integrated care limits back-related disability
An integrated approach to managing chronic back pain substantially reduces disability in patients' working and private lives, according to this study of 134 adults with a history of low back pain-related sickness absence. The integrated care provided to those in the study consisted of a workplace intervention based on participatory ergonomics, involving a supervisor, and a graded activity programme based on cognitive behavioural principles. The researchers studied how long workers were off sick due to low back pain before they were able to return to work on a sustained basis. Secondary outcomes included function and the intensity of pain experienced. Workers taking part in the integrated care programme took a median 88 days to return to sustainable work, compared with a median 208 days for those receiving "usual" care. After 12 months, those in the integrated care group improved their functional status significantly more than those receiving usual care, although there was little difference in pain experienced.
Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life, Ludeke C et al, British Medical Journal 2010; 340: c1035.
Cancer risk for Chinese medicine practitioners
Practitioners of traditional Chinese medicine with frequent exposure to herbal medicines have a significantly increased risk of liver and bladder cancers, according to this study. The mortality and cancer incidence rates of 7,675 physicians practising Chinese medicine between 1985 and 2005 were compared with those of the general population in Taiwan. However, in most other health respects, the news for this group of alternative practitioners is good. Over the 20-year period, the study cohort showed significantly lower standardised mortality for all causes, and for deaths from infectious, circulatory, respiratory digestive diseases. The practitioners also had significantly lower incidence rates for most cancers other than those highlighted, although the authors suggest that the reasons for the higher rates of liver and bladder cancers among the group warrant "further investigation".