Patient perspective on herpes zoster and its complications: an observational prospective study in patients aged over 50 years in general practice.

Abstract

Understanding the effect of herpes zoster and zoster-related pain should inform care to improve health-related quality of life in elderly patients. A 12-month, longitudinal, prospective, multicenter observational study conducted in primary care in France enrolled patients aged ≥ 50 years with acute eruptive herpes zoster. Patient-reported zoster-related pain was assessed by validated questionnaires (Douleur Neuropathique en 4 Questions [DN4], Zoster Brief Pain Inventory [ZBPI], and Neuropathic Pain Symptom Inventory [NPSI]) on days 0 and 15, and at months 1, 3, 6, 9, and 12. Health-related quality of life was assessed by the 12-item short-form health survey (SF-12) and the Hospital Anxiety and Depression scale on day 0 and at months 3, 6, and 12. Of 1358 patients included, 1032 completed follow-up. Mean ± standard deviation age was 67.7 ± 10.7 (range, 50-95) years; 62.2% were women. Most patients (94.1%) were prescribed antiviral drugs. The prevalence of zoster-related pain on day 0 and at months 3, 6, 9, and 12 was 79.6%, 11.6%, 8.5%, 7.4%, and 6.0%, respectively. Patients with persistent pain had lower scores on the physical and mental component summaries of the SF-12 and the ZBPI interference score than those without pain. By logistic regression analysis, main predictive factors on day 0 for postherpetic neuralgia at month 3 were age, male sex, ZBPI interference score, Physical Component Summary score of the SF-12, and neuropathic quality of pain (DN4 score ≥ 4). Despite early diagnosis and treatment with antiviral agents, many patients with herpes zoster experience persistent pain and marked long-term reduction in health-related quality of life.

• Authors: Didier Bouhassira, Olivier Chassany, Jacques Gaillat, Thomas Hanslik, Odile Launay, Claude Mann, Christian Rabaud, Olivier Rogeaux, Christophe Strady
• Journal: Pain (Pain) Vol. 153 Issue 2 Pg. 342-349 (Feb 2012) ISSN: 1872-6623 [Electronic] United States
• PMID: 22138256 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• Aging (psychology)
• Anxiety (diagnosis, epidemiology)
• Chronic Pain (epidemiology, psychology)
• Comorbidity
• Depression (diagnosis, epidemiology)
• Female
• Herpes Zoster (epidemiology, psychology)
• Humans
• Longitudinal Studies
• Male
• Middle Aged
• Neuralgia, Postherpetic (epidemiology, psychology)
• Prospective Studies