Clinical Outcomes and Treatment Costs of Low Back Pain using ICHOM Patient-reported Measures: A Real-world Study

Background: One of the main causes of disability and financial burden is low back pain (LBP). Despite being essential to value-based care, patient-reported outcome measure (PROM) is still not widely used in Saudi Arabia. Objectives: This study assessed the feasibility, clinical utility, and economic implications of implementing the ICHOM LBP Standard Set in routine insured care. Materials and Methods: For adults with LBP treated between August 2023 and March 2025, a retrospective study of anonymized PROM and insurance claims data was carried out. Disability, pain, quality of life, employment status, and expenses were among the outcomes that were measured at baseline, one, three, and 6 months. Data completeness and adherence to ICHOM follow-up schedules were used to assess feasibility. Results: There were 97 patients total (mean age 50 years; 88.7% male). PROM completion rates were high and on schedule. All outcomes showed significant improvements: Oswestry Disability Index scores improved, three-level EuroQol Five-Dimension questionnaire domains demonstrated recovery, and mean back pain dropped from 8.5 to 1.7. 58.8% of patients who were employed went back to work within a month, and 100% did so within 6 months. Clinical heterogeneity was reflected in the diversity of the median episode-level treatment costs, which were SAR 53,170. Conclusions: It is possible to enhance pain, function, quality of life, and return-to-work outcomes in Saudi Arabia by using the ICHOM LBP Standard Set. Value-based treatment is supported by PROM integration, and future research should standardize occupational and comorbidity data and evaluate multicenter implementation to maximize patient-centered, economical LBP management.