title: Measuring the burden of herpes zoster and post herpetic neuralgia within primary care in rural Crete, Greece.
abstract: BACKGROUND
  Research has indicated that general practitioners (GPs) have good clinical judgment in regards to diagnosing and managing herpes zoster (HZ) within clinical practice in a country with limited resources for primary care and general practice. The objective of the current study was to assess the burden of HZ and post herpetic neuralgia (PHN) within rural general practices in Crete, Greece.
  
  
  METHODS
  The current study took place within a rural setting in Crete, Greece during the period of November 2007 to November 2009 within the catchment area in which the Cretan Rural Practice-based Research Network is operating. In total 19 GP's from 14 health care units in rural Crete were invited to participate, covering a total turnover patient population of approximately 25, 000 subjects. For the purpose of this study an electronic record database was constructed and used as the main tool for monitoring HZ and PHN incidence. Stress related data was also collected with the use of the Short Anxiety Screening Test (SAST).
  
  
  RESULTS
  The crude incidence rate of HZ was 1.4/1000 patients/year throughout the entire network of health centers and satellite practices, while among satellite practices alone it was calculated at 1.3/1000 patients/year. Additionally, the standardised incidence density within satellite practices was calculated at 1.6/1000 patients/year. In regards to the stress associated with HZ and PHN, the latter were found to have lower levels of anxiety, as assessed through the SAST score (17.4 ± 3.9 vs. 21.1 ± 5.7; p = 0.029).
  
  
  CONCLUSIONS
  The implementation of an electronic surveillance system was feasible so as to measure the burden of HZ and PHN within the rural general practice setting in Crete.
authors.affiliation: Department of Social Medicine, Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, PO Box 2208, Postal Code 71003, Greece. lionis@galinos.med.uoc.gr
authors.forename: Christos D
authors.initials: CD
authors.lastname: Lionis
authors.forename: Constantine I
authors.initials: CI
authors.lastname: Vardavas
authors.forename: Emmanouil K
authors.initials: EK
authors.lastname: Symvoulakis
authors.forename: Maria G
authors.initials: MG
authors.lastname: Papadakaki
authors.forename: Foteini S
authors.initials: FS
authors.lastname: Anastasiou
authors.forename: Maria D
authors.initials: MD
authors.lastname: Antonopoulou
authors.forename: Charalampos M
authors.initials: CM
authors.lastname: Apostolakis
authors.forename: Stelios A
authors.initials: SA
authors.lastname: Dimitrakopoulos
authors.forename: George I
authors.initials: GI
authors.lastname: Fountakis
authors.forename: Ilias A
authors.initials: IA
authors.lastname: Grammatikopoulos
authors.forename: John D
authors.initials: JD
authors.lastname: Komninos
authors.forename: Dimitris K
authors.initials: DK
authors.lastname: Kounalakis
authors.forename: Eva S
authors.initials: ES
authors.lastname: Ladoukaki
authors.forename: Kornilia V
authors.initials: KV
authors.lastname: Makri
authors.forename: Chrysa S
authors.initials: CS
authors.lastname: Petraki
authors.forename: Nikos G
authors.initials: NG
authors.lastname: Ploumis
authors.forename: Dimitra P
authors.initials: DP
authors.lastname: Prokopiadou
authors.forename: Ioanna N
authors.initials: IN
authors.lastname: Stefanaki
authors.forename: Nikos A
authors.initials: NA
authors.lastname: Tsakountakis
authors.forename: Ioanna G
authors.initials: IG
authors.lastname: Tsiligianni
authors.forename: Emmanouil N
authors.initials: EN
authors.lastname: Tzortzis
authors.forename: Aggeliki A
authors.initials: AA
authors.lastname: Vasilaki
authors.forename: Theodoros K
authors.initials: TK
authors.lastname: Vasilopoulos
authors.forename: George E
authors.initials: GE
authors.lastname: Vrentzos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002391:Catchment Area, Health / Q000706:statistics & numerical data; D019058:Community Networks / Q000706:statistics & numerical data; D017281:Cost of Illness; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005194:Family Practice / Q000592:standards*; D005260:Female; D006115:Greece / Q000453:epidemiology; D006302:Health Services Research; D006562:Herpes Zoster / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology; D011320:Primary Health Care / Q000191:economics* / Q000706:statistics & numerical data; D011594:Psychometrics / Q000379:methods; D011785:Quality Assurance, Health Care / Q000379:methods*; D019035:Rural Health Services / Q000191:economics* / Q000592:standards / Q000706:statistics & numerical data; D018571:Sentinel Surveillance; D012923:Social Class; D013315:Stress, Psychological / Q000145:classification / Q000175:diagnosis