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Robert H. Dworkin - One of the best experts on this subject based on the ideXlab platform.

  • Natural history and treatment of Herpes Zoster.
    The journal of pain : official journal of the American Pain Society, 2020
    Co-Authors: Kenneth E. Schmader, Robert H. Dworkin
    Abstract:

    The objective of this article is to provide an overview of the natural history and treatment of Herpes Zoster, with a focus on Pain management. Herpes Zoster has the highest incidence of all neurological diseases, occurring annually in approximately 1 million people in the United States. A basic feature of Herpes Zoster is a marked increase in incidence with aging and with diseases and drugs that impair cellular immunity. Herpes Zoster begins with reactivation of varicella Zoster virus in dorsal root or cranial nerve ganglia, which is often accompanied by a prodrome of dermatomal Pain or abnormal sensations. Varicella Zoster virus spreads in the affected primary afferent nerve to the skin and produces a characteristic dermatomal maculopapular and vesicular rash and Pain. Herpes Zoster acute Pain lowers quality of life and interferes with activities of daily living. Antiviral therapy and scheduled analgesics form the pharmacotherapeutic foundation for Herpes Zoster acute Pain reduction. If moderate to severe Herpes Zoster Pain is not adequately relieved by antiviral agents in combination with oral analgesic medications, then corticosteroids, anticonvulsants (eg, gabapentin or pregabalin), tricyclic antidepressants (eg, nortriptyline or desipramine), or neural blockade can be considered. This article presents information on the clinical features and treatment of Herpes Zoster. This information will help clinicians diagnose and manage Herpes Zoster Pain.

  • brief research reports health care expenditure burden of persisting Herpes Zoster Pain
    2016
    Co-Authors: Robert H. Dworkin, Richard P White, Kevin Hawkins
    Abstract:

    ABSTRACT Objectives. Pain can persist long after the resolution of Herpes Zoster, but little is known regarding its health care costs. The objective of this study was to determine the health care expenditures associated with persisting Pain following Herpes Zoster by comparing expenditures for patients with postherpetic neuralgia or subacute herpetic neuralgia with a control group without these conditions. Methods. Health care expenditures attributable to persisting Pain in Herpes Zoster patients were calculated using Thomson-Medstat's MarketScan ® databases to examine commercial, Medicare, and Medicaid claims for inpatient and outpatient services and outpatient prescription drugs. Results. Excess annualized costs were $4,917 for commercially insured patients, $2,696 for Medicare patients, and $9,310 for Medicaid patients. Conclusions. The substantial health care costs associated with persisting Pain in Herpes Zoster have important public health implications given evidence that the incidence of Herpes Zoster is increasing and that the population is aging in the United States. The results provide a basis for evaluating the cost-effectiveness of existing treatments and emerging prevention strategies.

  • health care expenditure burden of persisting Herpes Zoster Pain
    Pain Medicine, 2008
    Co-Authors: Robert H. Dworkin, Richard E White, Alec B Oconnor, Kevin Hawkins
    Abstract:

    Objectives.  Pain can persist long after the resolution of Herpes Zoster, but little is known regarding its health care costs. The objective of this study was to determine the health care expenditures associated with persisting Pain following Herpes Zoster by comparing expenditures for patients with postherpetic neuralgia or subacute herpetic neuralgia with a control group without these conditions. Methods.  Health care expenditures attributable to persisting Pain in Herpes Zoster patients were calculated using Thomson-Medstat’s MarketScan® databases to examine commercial, Medicare, and Medicaid claims for inpatient and outpatient services and outpatient prescription drugs. Results.  Excess annualized costs were $4,917 for commercially insured patients, $2,696 for Medicare patients, and $9,310 for Medicaid patients. Conclusions.  The substantial health care costs associated with persisting Pain in Herpes Zoster have important public health implications given evidence that the incidence of Herpes Zoster is increasing and that the population is aging in the United States. The results provide a basis for evaluating the cost-effectiveness of existing treatments and emerging prevention strategies.

  • natural history and treatment of Herpes Zoster
    The Journal of Pain, 2008
    Co-Authors: Kenneth E. Schmader, Robert H. Dworkin
    Abstract:

    Abstract The objective of this article is to provide an overview of the natural history and treatment of Herpes Zoster, with a focus on Pain management. Herpes Zoster has the highest incidence of all neurological diseases, occurring annually in approximately 1 million people in the United States. A basic feature of Herpes Zoster is a marked increase in incidence with aging and with diseases and drugs that impair cellular immunity. Herpes Zoster begins with reactivation of varicella Zoster virus in dorsal root or cranial nerve ganglia, which is often accompanied by a prodrome of dermatomal Pain or abnormal sensations. Varicella Zoster virus spreads in the affected primary afferent nerve to the skin and produces a characteristic dermatomal maculopapular and vesicular rash and Pain. Herpes Zoster acute Pain lowers quality of life and interferes with activities of daily living. Antiviral therapy and scheduled analgesics form the pharmacotherapeutic foundation for Herpes Zoster acute Pain reduction. If moderate to severe Herpes Zoster Pain is not adequately relieved by antiviral agents in combination with oral analgesic medications, then corticosteroids, anticonvulsants (eg, gabapentin or pregabalin), tricyclic antidepressants (eg, nortriptyline or desipramine), or neural blockade can be considered. Perspective This article presents information on the clinical features and treatment of Herpes Zoster. This information will help clinicians diagnose and manage Herpes Zoster Pain.

  • healthcare costs of acute and chronic Pain associated with a diagnosis of Herpes Zoster
    Journal of the American Geriatrics Society, 2007
    Co-Authors: Robert H. Dworkin, Alec B Oconnor, Richard P White, Onur Baser, Kevin Hawkins
    Abstract:

    OBJECTIVES: To determine the healthcare costs of acute and chronic Pain associated with Herpes Zoster. DESIGN: Retrospective cohort analysis. SETTING: Inpatient and outpatient care. PARTICIPANTS: Patients were selected from Medicare, commercial insurance, and Medicaid claims databases if they had a diagnosis of Herpes Zoster or postherpetic neuralgia (PHN) or were prescribed analgesics after a diagnosis of Herpes Zoster (possible PHN) and were matched to controls for demographic and clinical factors using propensity scores. MEASUREMENTS: One-year excess healthcare expenditures attributable to Herpes Zoster Pain or PHN were calculated for inpatient, outpatient, and prescription drug services. RESULTS: For the Medicare cohort, the average excess cost per patient was $1,300 in the year after a diagnosis of Herpes Zoster with 30 days or fewer of analgesic use and ranged from $2,200 to $2,300 per patient with PHN or possible PHN. Patients with possible PHN were 53% more prevalent than patients with PHN in the Medicare cohort and accounted for half of all excess expenditures. Findings were similar in the younger cohorts with commercial insurance and Medicaid except that costs attributable to PHN and possible PHN were higher, and patients with possible PHN were three to five times as prevalent as patients with PHN. CONCLUSION: Healthcare costs associated with PHN were substantially greater than those associated with Herpes Zoster Pain that resolved within 30 days. The data suggest that as many as 80% of patients with PHN may not be diagnosed with PHN and that these patients account for at least half of PHN expenditures.

Kenneth E. Schmader - One of the best experts on this subject based on the ideXlab platform.

  • Natural history and treatment of Herpes Zoster.
    The journal of pain : official journal of the American Pain Society, 2020
    Co-Authors: Kenneth E. Schmader, Robert H. Dworkin
    Abstract:

    The objective of this article is to provide an overview of the natural history and treatment of Herpes Zoster, with a focus on Pain management. Herpes Zoster has the highest incidence of all neurological diseases, occurring annually in approximately 1 million people in the United States. A basic feature of Herpes Zoster is a marked increase in incidence with aging and with diseases and drugs that impair cellular immunity. Herpes Zoster begins with reactivation of varicella Zoster virus in dorsal root or cranial nerve ganglia, which is often accompanied by a prodrome of dermatomal Pain or abnormal sensations. Varicella Zoster virus spreads in the affected primary afferent nerve to the skin and produces a characteristic dermatomal maculopapular and vesicular rash and Pain. Herpes Zoster acute Pain lowers quality of life and interferes with activities of daily living. Antiviral therapy and scheduled analgesics form the pharmacotherapeutic foundation for Herpes Zoster acute Pain reduction. If moderate to severe Herpes Zoster Pain is not adequately relieved by antiviral agents in combination with oral analgesic medications, then corticosteroids, anticonvulsants (eg, gabapentin or pregabalin), tricyclic antidepressants (eg, nortriptyline or desipramine), or neural blockade can be considered. This article presents information on the clinical features and treatment of Herpes Zoster. This information will help clinicians diagnose and manage Herpes Zoster Pain.

  • association between prodromal Pain and the severity of acute Herpes Zoster and utilization of health care resources
    European Journal of Pain, 2011
    Co-Authors: Atika Benbernou, Kenneth E. Schmader, Robert W Johnson, Myron J Levin, Melanie Drolet, Michael N Oxman, David Patrick, Stephanie Camden, James A Mansi, Marc Brisson
    Abstract:

    Abstract Background Herpes Zoster results from the reactivation of the varicella-Zoster virus, which is often accompanied by a prodrome of dermatomal Pain. Little is known about the burden of prodromal Pain. Objectives (1) Describe the frequency, severity and duration of prodromal Pain; (2) determine the relationship between prodromal Pain and the characteristics of Herpes Zoster at recruitment and the utilization of health care resources. Methods Between 10/2005 and 07/2006, 251 subjects ⩾50 years old, seeking care for Herpes Zoster within 14 days of rash onset, were recruited across Canada. Severity and duration of prodromal Pain were measured retrospectively using the Initial Zoster Impact Questionnaire. The burden of prodromal Pain was obtained by the product of Pain severity and duration. The severity of acute Herpes Zoster Pain was measured using the Zoster Brief Pain Inventory. Results The majority of participants reported prodromal Pain (74%). Mean Pain duration and severity were 4.7 days and 6/10, respectively. Subjects aged 61–70 years old were more likely to report prodromal Pain (RR = 1.14, p -value = 0.02). The burden of prodromal Pain was greater in subjects not working ( p -value = 0.02) or immunosuppressed ( p -value = 0.04). Prodromal Pain was associated with more severe acute Pain (6.2 vs. 4.3, p -value  p -value = 0.04) and to visit the emergency room (RR = 2.56, p -value = 0.04). Conclusion The burden of prodromal Pain is significant and should be considered when evaluating the overall benefit of Herpes Zoster vaccination.

  • natural history and treatment of Herpes Zoster
    The Journal of Pain, 2008
    Co-Authors: Kenneth E. Schmader, Robert H. Dworkin
    Abstract:

    Abstract The objective of this article is to provide an overview of the natural history and treatment of Herpes Zoster, with a focus on Pain management. Herpes Zoster has the highest incidence of all neurological diseases, occurring annually in approximately 1 million people in the United States. A basic feature of Herpes Zoster is a marked increase in incidence with aging and with diseases and drugs that impair cellular immunity. Herpes Zoster begins with reactivation of varicella Zoster virus in dorsal root or cranial nerve ganglia, which is often accompanied by a prodrome of dermatomal Pain or abnormal sensations. Varicella Zoster virus spreads in the affected primary afferent nerve to the skin and produces a characteristic dermatomal maculopapular and vesicular rash and Pain. Herpes Zoster acute Pain lowers quality of life and interferes with activities of daily living. Antiviral therapy and scheduled analgesics form the pharmacotherapeutic foundation for Herpes Zoster acute Pain reduction. If moderate to severe Herpes Zoster Pain is not adequately relieved by antiviral agents in combination with oral analgesic medications, then corticosteroids, anticonvulsants (eg, gabapentin or pregabalin), tricyclic antidepressants (eg, nortriptyline or desipramine), or neural blockade can be considered. Perspective This article presents information on the clinical features and treatment of Herpes Zoster. This information will help clinicians diagnose and manage Herpes Zoster Pain.

  • the impact of acute Herpes Zoster Pain and discomfort on functional status and quality of life in older adults
    The Clinical Journal of Pain, 2007
    Co-Authors: Kenneth E. Schmader, Paul Coplan, Alexander Nikas, Ivan S F Chan, Peter W Choo, Myron J Levin, Richard Sloane, Carl F Pieper, Patricia Saddier, Gary R Johnson
    Abstract:

    Objectives To describe the interference of Herpes Zoster (HZ) Pain and discomfort with activities of daily living (ADLs) and health-related quality of life (HRQL) during the acute rash phase, and to quantify the relationship between acute HZ Pain and discomfort and impaired ADLs and HRQL in older persons. Methods Prospective, observational study of 160 HZ outpatients age ≥60 at 4 US study sites who completed the Zoster Brief Pain Inventory (ZBPI), Zoster Impact Questionnaire (ZIQ), McGill Pain Questionnaire, EuroQol, and SF-12 questionnaires on a predetermined schedule. Patients rated interference on a 0 to 10 scale for ADL items in the ZBPI and the ZIQ. Interference scores were averaged to create summary measures for the ZBPI items (ZBPI ADLI) and ZIQ items (ZIQ ADLI). A composite Pain score was used in mixed-effects models analyses of the association between Pain and discomfort and ADLI and HRQL measures during the first 35 days after HZ rash onset. Results HZ Pain interfered with all ADLs but interference was greatest for enjoyment of life, sleep, general activity, leisure activities, getting out of the house, and shopping. For every 1.0 point increase in Pain and discomfort intensity, there was a 0.69 and 0.53 point increase in ZBPI and ZIQ interference, respectively, and a 2.81 point, 1.57 point, and 1.95 point decrease in EuroQol, SF-12 physical, and SF-12 mental scales, respectively. Discussion Acute Zoster Pain and discomfort has a significant negative impact on functional status and HRQL in older adults. The magnitude of interference increases with increasing Pain and discomfort intensity.

  • the impact of acute Herpes Zoster Pain and discomfort on functional status and quality of life in older adults
    The Clinical Journal of Pain, 2007
    Co-Authors: Kenneth E. Schmader, Paul Coplan, Alexander Nikas, Ivan S F Chan, Peter W Choo, Myron J Levin, Richard Sloane, Carl F Pieper, Patricia Saddier, Gary R Johnson
    Abstract:

    OBJECTIVES: To describe the interference of Herpes Zoster (HZ) Pain and discomfort with activities of daily living (ADLs) and health-related quality of life (HRQL) during the acute rash phase, and to quantify the relationship between acute HZ Pain and discomfort and impaired ADLs and HRQL in older persons. METHODS: Prospective, observational study of 160 HZ outpatients age > or =60 at 4 US study sites who completed the Zoster Brief Pain Inventory (ZBPI), Zoster Impact Questionnaire (ZIQ), McGill Pain Questionnaire, EuroQol, and SF-12 questionnaires on a predetermined schedule. Patients rated interference on a 0 to 10 scale for ADL items in the ZBPI and the ZIQ. Interference scores were averaged to create summary measures for the ZBPI items (ZBPI ADLI) and ZIQ items (ZIQ ADLI). A composite Pain score was used in mixed-effects models analyses of the association between Pain and discomfort and ADLI and HRQL measures during the first 35 days after HZ rash onset. RESULTS: HZ Pain interfered with all ADLs but interference was greatest for enjoyment of life, sleep, general activity, leisure activities, getting out of the house, and shopping. For every 1.0 point increase in Pain and discomfort intensity, there was a 0.69 and 0.53 point increase in ZBPI and ZIQ interference, respectively, and a 2.81 point, 1.57 point, and 1.95 point decrease in EuroQol, SF-12 physical, and SF-12 mental scales, respectively. DISCUSSION: Acute Zoster Pain and discomfort has a significant negative impact on functional status and HRQL in older adults. The magnitude of interference increases with increasing Pain and discomfort intensity.

Gary R Johnson - One of the best experts on this subject based on the ideXlab platform.

  • the impact of acute Herpes Zoster Pain and discomfort on functional status and quality of life in older adults
    The Clinical Journal of Pain, 2007
    Co-Authors: Kenneth E. Schmader, Paul Coplan, Alexander Nikas, Ivan S F Chan, Peter W Choo, Myron J Levin, Richard Sloane, Carl F Pieper, Patricia Saddier, Gary R Johnson
    Abstract:

    OBJECTIVES: To describe the interference of Herpes Zoster (HZ) Pain and discomfort with activities of daily living (ADLs) and health-related quality of life (HRQL) during the acute rash phase, and to quantify the relationship between acute HZ Pain and discomfort and impaired ADLs and HRQL in older persons. METHODS: Prospective, observational study of 160 HZ outpatients age > or =60 at 4 US study sites who completed the Zoster Brief Pain Inventory (ZBPI), Zoster Impact Questionnaire (ZIQ), McGill Pain Questionnaire, EuroQol, and SF-12 questionnaires on a predetermined schedule. Patients rated interference on a 0 to 10 scale for ADL items in the ZBPI and the ZIQ. Interference scores were averaged to create summary measures for the ZBPI items (ZBPI ADLI) and ZIQ items (ZIQ ADLI). A composite Pain score was used in mixed-effects models analyses of the association between Pain and discomfort and ADLI and HRQL measures during the first 35 days after HZ rash onset. RESULTS: HZ Pain interfered with all ADLs but interference was greatest for enjoyment of life, sleep, general activity, leisure activities, getting out of the house, and shopping. For every 1.0 point increase in Pain and discomfort intensity, there was a 0.69 and 0.53 point increase in ZBPI and ZIQ interference, respectively, and a 2.81 point, 1.57 point, and 1.95 point decrease in EuroQol, SF-12 physical, and SF-12 mental scales, respectively. DISCUSSION: Acute Zoster Pain and discomfort has a significant negative impact on functional status and HRQL in older adults. The magnitude of interference increases with increasing Pain and discomfort intensity.

  • the impact of acute Herpes Zoster Pain and discomfort on functional status and quality of life in older adults
    The Clinical Journal of Pain, 2007
    Co-Authors: Kenneth E. Schmader, Paul Coplan, Alexander Nikas, Ivan S F Chan, Peter W Choo, Myron J Levin, Richard Sloane, Carl F Pieper, Patricia Saddier, Gary R Johnson
    Abstract:

    Objectives To describe the interference of Herpes Zoster (HZ) Pain and discomfort with activities of daily living (ADLs) and health-related quality of life (HRQL) during the acute rash phase, and to quantify the relationship between acute HZ Pain and discomfort and impaired ADLs and HRQL in older persons. Methods Prospective, observational study of 160 HZ outpatients age ≥60 at 4 US study sites who completed the Zoster Brief Pain Inventory (ZBPI), Zoster Impact Questionnaire (ZIQ), McGill Pain Questionnaire, EuroQol, and SF-12 questionnaires on a predetermined schedule. Patients rated interference on a 0 to 10 scale for ADL items in the ZBPI and the ZIQ. Interference scores were averaged to create summary measures for the ZBPI items (ZBPI ADLI) and ZIQ items (ZIQ ADLI). A composite Pain score was used in mixed-effects models analyses of the association between Pain and discomfort and ADLI and HRQL measures during the first 35 days after HZ rash onset. Results HZ Pain interfered with all ADLs but interference was greatest for enjoyment of life, sleep, general activity, leisure activities, getting out of the house, and shopping. For every 1.0 point increase in Pain and discomfort intensity, there was a 0.69 and 0.53 point increase in ZBPI and ZIQ interference, respectively, and a 2.81 point, 1.57 point, and 1.95 point decrease in EuroQol, SF-12 physical, and SF-12 mental scales, respectively. Discussion Acute Zoster Pain and discomfort has a significant negative impact on functional status and HRQL in older adults. The magnitude of interference increases with increasing Pain and discomfort intensity.

  • development of a measure of the burden of Pain due to Herpes Zoster and postherpetic neuralgia for prevention trials adaptation of the brief Pain inventory
    The Journal of Pain, 2004
    Co-Authors: Kenneth E. Schmader, Paul Coplan, Alexander Nikas, Ivan S F Chan, Peter W Choo, Myron J Levin, Gary R Johnson, Mark S Bauer, Heather M Williams
    Abstract:

    Abstract In preparation for clinical trials of a vaccine against Herpes Zoster (HZ), we conducted a prospective, observational study to evaluate (1) the Zoster Brief Pain Inventory (ZBPI), an HZ-specific questionnaire to quantify HZ Pain and discomfort, (2) an operational definition of postherpetic neuralgia (PHN), and (3) a severity-duration measure of the burden of illness caused by HZ. HZ patients aged 60 years or older (n = 121) were enrolled within 14 days of rash onset and completed ZBPI, McGill Pain Questionnaire Present Pain Intensity (PPI), quality of life (QoL), and activities of daily living (ADL) questionnaires on a predetermined schedule. Reliability, measured by intraclass correlation coefficients within 14 days of rash onset, ranged between 0.63 and 0.78. ZBPI Pain scores were strongly correlated with other Pain measures, interference with ADL, and worsening QoL. The operational definition of PHN, a ZBPI Pain score of 3 or greater occurring 90 or more days after rash onset, had high agreement with Pain worse than mild on the PPI (kappa = 0.72). The ZBPI Pain severity-duration measure had high correlations with severity-duration measures of ADL interference, worsening QoL, and other Pain scales. These findings support the validity and utility of the ZBPI, the definition of PHN, and the severity-duration measure of the burden of HZ illness. Perspective Herpes Zoster Pain, as measured by the ZBPI severity-duration measure, is associated with impairment in daily living activities and quality of life. The ZBPI measure appears useful for quantifying Herpes Zoster Pain, postherpetic neuralgia, and impairment in daily living activities for clinical trials of Herpes Zoster prevention.

Hung Fu Tseng - One of the best experts on this subject based on the ideXlab platform.

  • patient report of Herpes Zoster Pain incremental benefits of Zoster vaccine live
    Vaccine, 2019
    Co-Authors: Katia Bruxvoort, Anna S Liang, Rafael Harpaz, Lei Qian, Lina S Sy, Philip Larussa, Scott D Schmid, Harpreet S Takhar, Hung Fu Tseng
    Abstract:

    INTRODUCTION: Pain following Herpes Zoster (HZ) can persist for months and negatively impact quality of life. To evaluate the effect of Zoster vaccine live (ZVL) on progression of Pain following HZ, we conducted a prospective cohort study of HZ cases at Kaiser Permanente Southern California. METHODS: ZVL vaccinated and unvaccinated members aged ≥60 years with laboratory-confirmed HZ from January 18, 2012 to February 26, 2015 were followed up within 5 days of HZ diagnosis, and at 30, 60, and 90 days after diagnosis. Pain was assessed with the Zoster Brief Pain Inventory (ZBPI) on a 0-10 scale, using cut-points of ≥3, ≥5, and ≥7, with postherpetic neuralgia (PHN) defined as Pain ≥3 at 90 days. Log binomial regression was used to estimate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) associated with Pain, comparing vaccinated versus unvaccinated HZ patients. RESULTS: We interviewed 509 vaccinated and 509 unvaccinated HZ patients. ZVL was associated with significantly lower risks of HZ-related Pain at all time-points. The risk of PHN in vaccinated and unvaccinated patients, respectively, was 9.2% and 15.4% (aRR = 0.594, 95% CI: 0.413, 0.854); 2.0% and 4.8% of these patients reported Pain ≥7 (aRR = 0.332, 95% CI: 0.153, 0.721). Irrespective of vaccination, the risk of PHN was lower in adults aged <70 years versus those ≥70 years and was similar or lower in females versus males. CONCLUSION: We used laboratory confirmation of HZ cases and patient survey to show that aside from preventing HZ, ZVL reduced HZ-related Pain and prevented PHN among vaccine recipients who experienced HZ. Observational studies will be needed to evaluate long-term effectiveness of the new recombinant Zoster vaccine and its benefits in protecting patients against PHN.

  • Patient report of Herpes Zoster Pain: Incremental benefits of Zoster vaccine live.
    Vaccine, 2019
    Co-Authors: Katia Bruxvoort, Anna S Liang, Rafael Harpaz, Lei Qian, Lina S Sy, Philip Larussa, Harpreet S Takhar, D. Scott Schmid, Hung Fu Tseng
    Abstract:

    INTRODUCTION: Pain following Herpes Zoster (HZ) can persist for months and negatively impact quality of life. To evaluate the effect of Zoster vaccine live (ZVL) on progression of Pain following HZ, we conducted a prospective cohort study of HZ cases at Kaiser Permanente Southern California. METHODS: ZVL vaccinated and unvaccinated members aged ≥60 years with laboratory-confirmed HZ from January 18, 2012 to February 26, 2015 were followed up within 5 days of HZ diagnosis, and at 30, 60, and 90 days after diagnosis. Pain was assessed with the Zoster Brief Pain Inventory (ZBPI) on a 0-10 scale, using cut-points of ≥3, ≥5, and ≥7, with postherpetic neuralgia (PHN) defined as Pain ≥3 at 90 days. Log binomial regression was used to estimate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) associated with Pain, comparing vaccinated versus unvaccinated HZ patients. RESULTS: We interviewed 509 vaccinated and 509 unvaccinated HZ patients. ZVL was associated with significantly lower risks of HZ-related Pain at all time-points. The risk of PHN in vaccinated and unvaccinated patients, respectively, was 9.2% and 15.4% (aRR = 0.594, 95% CI: 0.413, 0.854); 2.0% and 4.8% of these patients reported Pain ≥7 (aRR = 0.332, 95% CI: 0.153, 0.721). Irrespective of vaccination, the risk of PHN was lower in adults aged

Paul Coplan - One of the best experts on this subject based on the ideXlab platform.

  • the impact of acute Herpes Zoster Pain and discomfort on functional status and quality of life in older adults
    The Clinical Journal of Pain, 2007
    Co-Authors: Kenneth E. Schmader, Paul Coplan, Alexander Nikas, Ivan S F Chan, Peter W Choo, Myron J Levin, Richard Sloane, Carl F Pieper, Patricia Saddier, Gary R Johnson
    Abstract:

    OBJECTIVES: To describe the interference of Herpes Zoster (HZ) Pain and discomfort with activities of daily living (ADLs) and health-related quality of life (HRQL) during the acute rash phase, and to quantify the relationship between acute HZ Pain and discomfort and impaired ADLs and HRQL in older persons. METHODS: Prospective, observational study of 160 HZ outpatients age > or =60 at 4 US study sites who completed the Zoster Brief Pain Inventory (ZBPI), Zoster Impact Questionnaire (ZIQ), McGill Pain Questionnaire, EuroQol, and SF-12 questionnaires on a predetermined schedule. Patients rated interference on a 0 to 10 scale for ADL items in the ZBPI and the ZIQ. Interference scores were averaged to create summary measures for the ZBPI items (ZBPI ADLI) and ZIQ items (ZIQ ADLI). A composite Pain score was used in mixed-effects models analyses of the association between Pain and discomfort and ADLI and HRQL measures during the first 35 days after HZ rash onset. RESULTS: HZ Pain interfered with all ADLs but interference was greatest for enjoyment of life, sleep, general activity, leisure activities, getting out of the house, and shopping. For every 1.0 point increase in Pain and discomfort intensity, there was a 0.69 and 0.53 point increase in ZBPI and ZIQ interference, respectively, and a 2.81 point, 1.57 point, and 1.95 point decrease in EuroQol, SF-12 physical, and SF-12 mental scales, respectively. DISCUSSION: Acute Zoster Pain and discomfort has a significant negative impact on functional status and HRQL in older adults. The magnitude of interference increases with increasing Pain and discomfort intensity.

  • the impact of acute Herpes Zoster Pain and discomfort on functional status and quality of life in older adults
    The Clinical Journal of Pain, 2007
    Co-Authors: Kenneth E. Schmader, Paul Coplan, Alexander Nikas, Ivan S F Chan, Peter W Choo, Myron J Levin, Richard Sloane, Carl F Pieper, Patricia Saddier, Gary R Johnson
    Abstract:

    Objectives To describe the interference of Herpes Zoster (HZ) Pain and discomfort with activities of daily living (ADLs) and health-related quality of life (HRQL) during the acute rash phase, and to quantify the relationship between acute HZ Pain and discomfort and impaired ADLs and HRQL in older persons. Methods Prospective, observational study of 160 HZ outpatients age ≥60 at 4 US study sites who completed the Zoster Brief Pain Inventory (ZBPI), Zoster Impact Questionnaire (ZIQ), McGill Pain Questionnaire, EuroQol, and SF-12 questionnaires on a predetermined schedule. Patients rated interference on a 0 to 10 scale for ADL items in the ZBPI and the ZIQ. Interference scores were averaged to create summary measures for the ZBPI items (ZBPI ADLI) and ZIQ items (ZIQ ADLI). A composite Pain score was used in mixed-effects models analyses of the association between Pain and discomfort and ADLI and HRQL measures during the first 35 days after HZ rash onset. Results HZ Pain interfered with all ADLs but interference was greatest for enjoyment of life, sleep, general activity, leisure activities, getting out of the house, and shopping. For every 1.0 point increase in Pain and discomfort intensity, there was a 0.69 and 0.53 point increase in ZBPI and ZIQ interference, respectively, and a 2.81 point, 1.57 point, and 1.95 point decrease in EuroQol, SF-12 physical, and SF-12 mental scales, respectively. Discussion Acute Zoster Pain and discomfort has a significant negative impact on functional status and HRQL in older adults. The magnitude of interference increases with increasing Pain and discomfort intensity.

  • development of a measure of the burden of Pain due to Herpes Zoster and postherpetic neuralgia for prevention trials adaptation of the brief Pain inventory
    The Journal of Pain, 2004
    Co-Authors: Kenneth E. Schmader, Paul Coplan, Alexander Nikas, Ivan S F Chan, Peter W Choo, Myron J Levin, Gary R Johnson, Mark S Bauer, Heather M Williams
    Abstract:

    Abstract In preparation for clinical trials of a vaccine against Herpes Zoster (HZ), we conducted a prospective, observational study to evaluate (1) the Zoster Brief Pain Inventory (ZBPI), an HZ-specific questionnaire to quantify HZ Pain and discomfort, (2) an operational definition of postherpetic neuralgia (PHN), and (3) a severity-duration measure of the burden of illness caused by HZ. HZ patients aged 60 years or older (n = 121) were enrolled within 14 days of rash onset and completed ZBPI, McGill Pain Questionnaire Present Pain Intensity (PPI), quality of life (QoL), and activities of daily living (ADL) questionnaires on a predetermined schedule. Reliability, measured by intraclass correlation coefficients within 14 days of rash onset, ranged between 0.63 and 0.78. ZBPI Pain scores were strongly correlated with other Pain measures, interference with ADL, and worsening QoL. The operational definition of PHN, a ZBPI Pain score of 3 or greater occurring 90 or more days after rash onset, had high agreement with Pain worse than mild on the PPI (kappa = 0.72). The ZBPI Pain severity-duration measure had high correlations with severity-duration measures of ADL interference, worsening QoL, and other Pain scales. These findings support the validity and utility of the ZBPI, the definition of PHN, and the severity-duration measure of the burden of HZ illness. Perspective Herpes Zoster Pain, as measured by the ZBPI severity-duration measure, is associated with impairment in daily living activities and quality of life. The ZBPI measure appears useful for quantifying Herpes Zoster Pain, postherpetic neuralgia, and impairment in daily living activities for clinical trials of Herpes Zoster prevention.