title: Association between work time loss and quality of life in patients with Herpes Zoster: a pooled analysis of the MASTER studies.
abstract: BACKGROUND
  Herpes zoster (HZ) has a significant negative effect on the productive work life of individuals, and has been shown to be responsible for cases of absenteeism, presenteeism and decreased work effectiveness. The aim of this study was to evaluate health utility scores and associated predictors in an actively employed population of Herpes Zoster (HZ) patients with and without work time loss (WTL).
  
  
  METHODS
  This was a pooled analysis of the prospective, observational MASTER cohort studies, conducted in 8 countries across North America, Latin America and Asia. A total of 428 HZ patients engaged in full or part time work were included. WTL, defined as missing ≥ 1 partial or full work day, and work effectiveness, reported on a scale of 0-100%, were evaluated with the Work and Productivity Questionnaire (WPQ). The Pearson product-moment correlation was used to assess the correlation between work effectiveness and HRQoL. Mixed models with repeated measures assessed the relationship between HZ-related WTL over a 6-month follow-up period, and HRQoL, as evaluated by the EQ-5D. Additional predictors of HRQoL were also identified.
  
  
  RESULTS
  Overall, 57.7% of respondents reported WTL. Mean (SD) percent work effectiveness of patients in the WTL group was significantly lower compared to non-WTL (NWTL) patients at baseline [50.3 (31.6) vs. 71.4 (27.8); p < 0.001]. Patients in the WTL group also reported lower health utility scores at baseline and overall than their NWTL counterparts, with WTL identified as an independent negative predictor of both the EQ-5D summary scores and the EQ-5D VAS (p < 0.001). Decrease in work effectiveness was negatively associated with HRQoL overall (p < 0.001). Predictors of lower HRQoL were worst Zoster Brief Pain Inventory (ZBPI) pain score, the presence of HZ complications and country income (predictor of EQ-5D VAS only).
  
  
  CONCLUSIONS
  HZ adversely impacts the work and productive life of actively employed individuals. In turn, HZ-related reductions in work effectiveness and work time are associated with a negative effect on HRQoL.
authors.affiliation: JSS Medical Research, 9400 Henri-Bourassa W, St-Laurent, QC, H4S 1N8, Canada.
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Rampakakis
authors.affiliation: JSS Medical Research, 9400 Henri-Bourassa W, St-Laurent, QC, H4S 1N8, Canada.
authors.forename: Melissa
authors.initials: M
authors.lastname: Stutz
authors.affiliation: Clinical Research Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave., Boston, MA, 02115, USA.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kawai
authors.affiliation: Department of Dermatology, National Taiwan University Hospital, No. 7, Zhongshan South Road, Zhongzheng District, Taipei City, 100, Taiwan.
authors.forename: Tsen-Fang
authors.initials: TF
authors.lastname: Tsai
authors.affiliation: Division of Infectious diseases, Department of Internal Medicine, Korea University Guro Hospital, 145 Anam-ro, Seongbuk-gu, Seoul, South Korea.
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Cheong
authors.affiliation: Clinical Infectious Disease Research Unit, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand.
authors.forename: Jittima
authors.initials: J
authors.lastname: Dhitavat
authors.affiliation: Hospital Civil de Guadalajara Fray Antonio Alcalde, Calle Coronel Calderón #777, El Retiro, 44280, Guadalajara, Jalisco, Mexico.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Ortiz-Covarrubias
authors.affiliation: Vaccines Latin America & the Caribbean, MSD Corp., Av. San Jerónimo 369 Piso 8, Col. La Otra Banda, Mexico City, CP 01090, Mexico.
authors.forename: Miguel
authors.initials: M
authors.lastname: Cashat-Cruz
authors.affiliation: Latin America Health Outcomes Research, MSD (I.A.) Corp., P.O. Box 3689, Carolina, PR, 00984-3689, Puerto Rico.
authors.forename: Homero
authors.initials: H
authors.lastname: Monsanto
authors.affiliation: Center for Observational and Real-World Evidence, Merck & Co., Inc., 2000 Galloping Hill Rd, Kenilworth, NJ, 07033, USA.
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Johnson
authors.affiliation: JSS Medical Research, 9400 Henri-Bourassa W, St-Laurent, QC, H4S 1N8, Canada. submission@jssresearch.com.|McGill University, 845 Sherbrooke Street W, Montreal, QC, H3A 0G4, Canada. submission@jssresearch.com.
authors.forename: John S
authors.initials: JS
authors.lastname: Sampalis
authors.affiliation: Center for Observational and Real-World Evidence, Merck & Co., Inc., 2000 Galloping Hill Rd, Kenilworth, NJ, 07033, USA.
authors.forename: Camilo J
authors.initials: CJ
authors.lastname: Acosta
mesh_terms: D000041:Absenteeism; D000328:Adult; D000368:Aged; D001208:Asia / Q000453:epidemiology; D015331:Cohort Studies; D004185:Disability Evaluation; D004526:Efficiency; D005260:Female; D006562:Herpes Zoster / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014940:Work Schedule Tolerance
keywords: Herpes Zoster; Observational study; Quality of life; Work