A cross-sectional survey of work and income loss consideration among patients with herpes zoster when completing a quality of life questionnaire

Abstract

BackgroundPrior research suggests that many patients do not spontaneously include work/income loss when responding to utility assessments, although this remains unconfirmed in the US due to almost no published US-based studies to date, and has not been previously studied among patients with herpes zoster (HZ). The objective of this study was to examine whether patients with HZ consider work and income loss when completing a quality of life survey.MethodsA cross-sectional survey was administered to 2000 US adult commercial health plan enrollees aged 50–64 years with ≥ 1 HZ medical claim during 2014. The survey collected information related to health status (EQ-5D), work productivity, and HZ severity and clinical features.ResultsMean respondent age was 58.4 years [standard deviation (SD) 4.1] and 62.0% were female. About 3 in 4 (76.8%) patients (N = 772) were employed either full (69.9%) or part time (6.9%). Less than half (45%) spontaneously considered work/income loss when responding to EQ-5D, and mean EQ-5D scores for patients who considered work/income loss were lower than for patients who did not [0.56 (SD = 0.28) vs. 0.69 (SD = 0.24); p < 0.001]. Overall, 43% of patients reported at least one full day missed (mean = 9 full days) and 29% reported at least one partial day missed (mean = 6 partial days) during the most recent shingles episode. Patients who considered work loss were more likely to have missed full (76.4% vs 26.0%, p < 0.001) or partial (70.9% vs. 35.2%, p < 0.001) days. Patients with absenteeism were more likely to consider work/income loss when completing EQ-5D [odds ratio (OR) = 7.91, 95% confidence interval (CI) 5.01–12.31]. Odds of absenteeism/presenteeism increased significantly with increasing levels of HZ severity, and higher odds were associated with pain located on the face/scalp/neck/eye/ear (OR 1.90, 95% CI 1.06–3.40) and with pain lasting 12+ months (OR = 2.91, 95% CI 1.14–7.42).ConclusionsHZ has considerable impact on the work and productivity of adults aged 50–64 years old. However, many patients with HZ do not spontaneously consider work/income loss when completing a standardized quality of life questionnaire. Studies that use health state utilities in HZ based on EQ-5D may not fully reflect the societal costs of work loss.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3451-9) contains supplementary material, which is available to authorized users.

Impact of herpes zoster and post-herpetic neuralgia on health-related quality of life in Miyun District of Beijing, China: An EQ-5D survey

“…Our findings indicates that PHN has a similar serious impact on HRQoL at different ages, and the reported proportion and QALY loss in each dimension with PHN were higher than those with HZ, indicating a much greater impact of PHN than that of HZ. PHN can also affect the physical and mental QoL of younger working populations who must returned to work while still experiencing substantial pain and other symptoms [35] . Among patients aged 0–14 years, no problems were reported in the four dimensions except for pain/discomfort, which may be related to the small number of patients (n = 5) and short duration of disease (13.20 days).…”