Abstract
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.
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Notes
Respondents could select multiple options for second line analgesia for PHN pain. The denominator (N=727) reflects the total number of preferences selected by respondents.
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Acknowledgements
We would like to acknowledge the dedicated role of the Irish Sentinel GP network in gathering and summating patient data, in particular those involved in the surveillance of AHZ.
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Crosbie, B., Lucey, S., Tilson, L. et al. Acute herpes zoster and post herpetic neuralgia in primary care: a study of diagnosis, treatment and cost. Eur J Clin Microbiol Infect Dis 37, 627–631 (2018). https://doi.org/10.1007/s10096-017-3153-y
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DOI: https://doi.org/10.1007/s10096-017-3153-y