Low Trend for VZV-Associated Disease Patients to Visit Neurologists

Abstract

Background Herpes zoster (HZ) is a skin disease that can also cause virus-infectious peripheral neuropathies. Despite this, there is limited information on patient preferences for seeking medical attention for HZ and zoster-associated pain (ZAP). Our study aimed to evaluate how frequently patients with ZAP choose to visit neurologists for their symptoms. Methods This study conducted a retrospective review of electronic health records in three general hospitals from January 2017 to June 2022. Using association rule mining, the study analyzed referral behaviors. Results We identified 33,633 patients with 111,488 outpatient visits over 5.5 years. The study found that the majority of patients (74.77–91.22%) visited dermatologists during their first outpatient visit, while only a small percentage (0.86–1.47%) preferred to consult a neurologist. The proportion of patients referred to a specialist during their medical visit varied significantly between different specialties within the same hospital (p <0.05) and even within the same specialty (p<0.05). There was a weak association (Lift:1.00–1.17) of referral behaviors between dermatology and neurology. Across the three hospitals, the average number of visits to a neurologist for ZAP was 1.42–2.49, with an average electronic health record duration of 11–15 days per patient. After consulting with a neurologist, some patients were referred to other specialists. Conclusion It was observed that patients with HZ and ZAP tended to visit a variety of specialists, with only a small number seeking the assistance of neurologists. However, from the perspective of neuroprotection, it is the duty of neurologists to provide more means.

Knowledge, attitude, and practice toward herpes zoster (HZ) and HZ vaccination: Concept elicitation findings from a multi-country study in the Asia Pacific

“…A previous study conducted in China reported that patients with HZ, PHN, and zoster-associated pain primarily visited dermatology and pain management specialists. 41 Neurologist consultations were more important in severe cases of HZ, where neuropathic zoster-associated pain and PHN cause extensive nerve injuries (e.g., VZV vasculitis). 41 As neurologists are not frequently involved in the management of HZ cases and assessment of vaccinations, they were not interviewed in this study.…”

“… 41 Neurologist consultations were more important in severe cases of HZ, where neuropathic zoster-associated pain and PHN cause extensive nerve injuries (e.g., VZV vasculitis). 41 As neurologists are not frequently involved in the management of HZ cases and assessment of vaccinations, they were not interviewed in this study.…”