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Observational Study
. 2016 Feb 18;6(2):e009689.
doi: 10.1136/bmjopen-2015-009689.

Is herpes zoster an additional complication in old age alongside comorbidity and multiple medications? Results of the post hoc analysis of the 12-month longitudinal prospective observational ARIZONA cohort study

Gisèle Pickering  1 , Gaëtan Gavazzi  2 , Jacques Gaillat  3 , Marc Paccalin  4 , Karine Bloch  5 , Didier Bouhassira  6
Affiliations
Observational Study

Is herpes zoster an additional complication in old age alongside comorbidity and multiple medications? Results of the post hoc analysis of the 12-month longitudinal prospective observational ARIZONA cohort study

Gisèle Pickering et al. BMJ Open. .

Abstract

Objectives: To examine the burden of comorbidity, polypharmacy and herpes zoster (HZ), an infectious disease, and its main complication post-herpetic neuralgia (PHN) in young (50-70 years of age: 70-) and old (≥ 70 years of age: 70+) patients.

Design: Post hoc analysis of the results of the 12-month longitudinal prospective multicentre observational ARIZONA cohort study.

Settings and participants: The study took place in primary care in France from 20 November 2006 to 12 September 2008. Overall, 644 general practitioners (GPs) collected data from 1358 patients aged 50 years or more with acute eruptive HZ.

Outcome measures: Presence of HZ-related pain or PHN (pain persisting >3 months) was documented at day 0 and at months 3, 6, and 12. To investigate HZ and PHN burden, pain, quality of life (QoL) and mood were self-assessed using validated questionnaires (Zoster Brief Pain Inventory, 12-item Short-Form health survey and Hospital Anxiety and Depression Scale, respectively).

Results: As compared with younger patients, older patients more frequently presented with comorbidities, more frequently took analgesics and had poorer response on all questionnaires, indicating greater burden, at inclusion. Analgesics were more frequently prescribed to relieve acute pain or PHN in 70+ than 70- patients. Despite higher levels of medication prescription, poorer pain relief and poorer response to all questionnaires were reported in 70+ than 70- patients.

Conclusions: Occurrence of HZ and progression to PHN adds extra burden on top of pharmacological treatment and impaired quality of life, especially in older patients who already have health problems to cope with in everyday life.

Keywords: GERIATRIC MEDICINE.

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Figures

Figure 1
Figure 1
Study flow chart. GPs, general practitioners.
Figure 2
Figure 2
SF12 quality of life at inclusion and follow-up in patients with or without post-herpetic neuralgia (PHN). Comparison between 70− and 70+ patients: (A) Physical Component Score (PCS) (p<0.01 at all time points); (B) Physical Functioning (p<0.01 at all time points); (C) Vitality (p<0.01 at all time points); (D) General Health (p<0.01 at all time points). SF12, Short-Form health survey.
Figure 3
Figure 3
Depression scores (HADS) at inclusion and follow-up. HADS, Hospital Anxiety and Depression Scale.
See this image and copyright information in PMC

References

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