title: Is herpes zoster an additional complication in old age alongside comorbidity and multiple medications? Results of the post hoc analysis of the 12-month longitudinal prospective observational ARIZONA cohort study.
abstract: OBJECTIVE
  To examine the burden of comorbidity, polypharmacy and herpes zoster (HZ), an infectious disease, and its main complication post-herpetic neuralgia (PHN) in young (50-70 years of age: 70-) and old (≥ 70 years of age: 70+) patients.
  
  
  METHODS
  Post hoc analysis of the results of the 12-month longitudinal prospective multicentre observational ARIZONA cohort study.
  
  
  METHODS
  The study took place in primary care in France from 20 November 2006 to 12 September 2008. Overall, 644 general practitioners (GPs) collected data from 1358 patients aged 50 years or more with acute eruptive HZ.
  
  
  METHODS
  Presence of HZ-related pain or PHN (pain persisting >3 months) was documented at day 0 and at months 3, 6, and 12. To investigate HZ and PHN burden, pain, quality of life (QoL) and mood were self-assessed using validated questionnaires (Zoster Brief Pain Inventory, 12-item Short-Form health survey and Hospital Anxiety and Depression Scale, respectively).
  
  
  RESULTS
  As compared with younger patients, older patients more frequently presented with comorbidities, more frequently took analgesics and had poorer response on all questionnaires, indicating greater burden, at inclusion. Analgesics were more frequently prescribed to relieve acute pain or PHN in 70+ than 70- patients. Despite higher levels of medication prescription, poorer pain relief and poorer response to all questionnaires were reported in 70+ than 70- patients.
  
  
  CONCLUSIONS
  Occurrence of HZ and progression to PHN adds extra burden on top of pharmacological treatment and impaired quality of life, especially in older patients who already have health problems to cope with in everyday life.
authors.affiliation: CHU Clermont-Ferrand, Centre de Pharmacologie Clinique, F-63003 Clermont-Ferrand, France Inserm CIC 1405, Inserm 1107, Clermont-Ferrand, France Clermont Université, Laboratoire de Pharmacologie, Faculté de Médecine, Clermont-Ferrand, France.
authors.forename: Gisèle
authors.initials: G
authors.lastname: Pickering
authors.affiliation: Département de Gériatrie, CHU de Grenoble, Grenoble, France.
authors.forename: Gaëtan
authors.initials: G
authors.lastname: Gavazzi
authors.affiliation: Service des Maladies Infectieuses, Centre Hospitalier de la Région d'Annecy, Pringy, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Gaillat
authors.affiliation: Département de Gériatrie, Hôpital de la Milétrie, CHU de Poitiers, Poitiers, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Paccalin
authors.affiliation: Laboratoire Sanofi-Pasteur MSD, Lyon, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Bloch
authors.affiliation: INSERM U987, Centre d'Evaluation et de Traitement de la Douleur, Hôpital Ambroise Paré, Boulogne-Billancourt, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Bouhassira
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D015897:Comorbidity; D005602:France / Q000453:epidemiology; D006562:Herpes Zoster / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D019338:Polypharmacy; D011446:Prospective Studies; D011788:Quality of Life
keywords: GERIATRIC MEDICINE