Acute herpes zoster and post herpetic neuralgia in primary care: a study of diagnosis, treatment and cost

Acute herpes zoster and its complication post herpetic neuralgia represent a significant challenge to primary care physicians in their care of an ageing population of patients. This was a cross-sectional observational study by means of a quantitative survey of 1,000 general practitioners registered...

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Bibliographic Details
Published in:European journal of clinical microbiology & infectious diseases 2018-04, Vol.37 (4), p.627-631
Main Authors: Crosbie, Brendan, Lucey, Sinead, Tilson, Lesley, Domegan, Lisa, Kieran, Jennifer
Format: Article
Language:English
Subjects:
Analgesics
Antiviral agents
Biomedical and Life Sciences
Biomedicine
Diagnosis
Famciclovir
Health care
Herpes zoster
Internal Medicine
Medical Microbiology
Narcotics
Neuralgia
Observational studies
Opioids
Original Article
Pain
Patients
Physicians
Primary care
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Summary:Acute herpes zoster and its complication post herpetic neuralgia represent a significant challenge to primary care physicians in their care of an ageing population of patients. This was a cross-sectional observational study by means of a quantitative survey of 1,000 general practitioners registered in Ireland exploring the frequency of diagnosis, methods of treatment and cost of AHZ and PHN in primary care. We recorded an 18% response rate ( n  = 184) with an 83% completion rate ( n  = 152/184). 80% of cases of AHZ occurred in patients aged 50 years or more with 81% of study participants encountering cases at a rate of 1–3 patients per month. Famciclovir (37%) and valaciclovir (36%) were the most commonly prescribed antiviral agents. Mild opioids (32%) were the most common analgesic agents used for first line AHZ pain, and pregabalin (37%) the most commonly prescribed analgesic agent for second line AHZ pain. Pregabalin was also the most commonly prescribed analgesic for both first and second line PHN pain (29% and 24%, respectively). The mean per-case direct cost (medication and GP visits) of treating AHZ and PHN in primary care was €195 (range €153–€236) and €201 (range €140–€313), respectively. Based on national sentinel data the estimated annual direct costs of treating AHZ and PHN in primary care is €2,278,196 (range €1,793,399–€2, 763,445). The treatment of AHZ and PHN represents both a significant care and cost burden on primary care resources in Ireland in keeping with other European based studies.
ISSN:0934-9723
1435-4373
DOI:10.1007/s10096-017-3153-y