The impact of acute herpes zoster pain and discomfort on functional status and quality of life in older adults.
OBJECTIVE
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.


CONCLUSIONS
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.
Schmader
Kenneth E
KE
Duke University, Durham, NC, USA. schma001@mc.duke.edu
Sloane
Richard
R
Pieper
Carl
C
Coplan
Paul M
PM
Nikas
Alexander
A
Saddier
Patricia
P
Chan
Ivan S F
IS
Choo
Peter
P
Levin
Myron J
MJ
Johnson
Gary
G
Williams
Heather M
HM
Oxman
Michael N
MN
D000208:Acute Disease; D000368:Aged; D003627:Data Interpretation, Statistical; D005260:Female; D006562:Herpes Zoster / Q000150:complications* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000523:psychology*; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires