Herpes zoster-associated severity and duration of pain, health-related quality of life, and healthcare utilization in Taiwan: a prospective observational study

BackgroundTo assess the severity and duration of herpes zoster (HZ)-associated pain (ZAP) and its impact on quality of life (QoL) and healthcare utilization (HCRU) from a patient perspective in routine care in Taiwan. MethodsA prospective, observational, single-cohort study was conducted in five centers across Taiwan. Patients were recruited at different time points during their HZ episode and were followed for 180days. ZAP was assessed with the Initial Zoster Impact Questionnaire and the Zoster Brief Pain Inventory, QoL with the EQ-5D, and HCRU with a simple questionnaire. ResultsA total of 150 patients were included with a mean age of 64.9years and mean time since rash onset of 18.8days. Prodromal pain was experienced by 64.7% of patients, of whom 91.8% reported moderate-to-severe pain. At enrollment, 98.0% of patients experienced ZAP. MeanSD worst pain score decreased from 5.95 +/- 3.09 at enrollment to 2.65 +/- 2.98 at 30days and 0.28 +/- 0.83 at 180days. Postherpetic neuralgia was observed in 20.7% of patients. Mean +/- SD EQ-5D score significantly decreased (P<0.001) from 0.91 +/- 0.16 before rash onset to 0.67 +/- 0.18 after rash onset, showing significant QoL deterioration up to 60days. The impact of HZ on QoL and pain severity was similar across age groups. Significant HCRU was observed including visits to the doctor (83.3% of patients), specialist (30.7%), emergency department (24.7%), physiotherapist (23.3%), and hospitalizations (20.7%). ConclusionSevere morbidity and significant HCRU are associated with HZ in Taiwan, supporting the need for early intervention and preventive strategies to reduce the HZ-associated burden of illness