Measurement of the burden, resources use and health costs associated with herpes zoster and post-herpetic neuralgia in mexico. Master study

Abstract

OBJECTIVES: Understand the burden of disease, resources utilization, and health costs associated to herpes zoster in Mexican population. METHOD(S): Canadian MASTER protocol methodology was adapted to perform this prospective cohort, multicenter trial in patients over 50 years who presented herpes zoster outbreaks or pain associated to zoster. Data was obtained through patient questionnaires at day 0, 14, 21, 30, 60, 90, 120, 150 and 180. Burden of disease was evaluated as a function of pain duration and severity measured with the Zoster Brief Pain Inventory and the Initial Zoster Impact questionnaire. Quality of Life was evaluated before and after a zoster rash with the EuroQol-5D. A simple questionnaire describing the health resources utilization was used as well as productivity and work questionnaires. Descriptive statistics for all variables were used and for continuous variables, mean, median, standard deviation, rank and confidence intervals were calculated RESULTS: 131 patients were enrolled. Mean age was 63.5 +/- 10.4 years. At the time of recruitment, 93 patients (71.0%) had papule-vesicles. Mean duration of evolution was 23.9 +/- 19.9 days. Median value of EQ VAS initially decreased to 63.8 during visit 1; nevertheless, it increased progressively to > 80 on visit 4 (21 days). The most important effects of post-herpetic pain on QoL occurred in daily activities, pain/discomfort, and anxiety/depression. Health resources were used mainly on the first visit. Health resources use consisted of medical consultation, chiropractic/physical therapy, psychiatry/psychology consultation, and specialists consultation. Nearly 50% of the patients needed support during the first visit and spent $1,045 MX (US $80.64) and $296,00 MX (US $22.84) on medication and alternative medicine, respectively. CONCLUSION(S): HZ is associated with impaired QoL, and significant health care resources use, supporting the need for early intervention and preventive strategies to reduce the HZ-associated disease burden to the health care system and the patient.