Background
Methods
Study design
Patient population
Treatment and follow-up
Pooled analysis outcome measures
Work productivity and work time loss
Health related quality of life
HZ-associated pain
Statistical analysis
Results
Baseline socio-demographic and disease characteristics
Variable | Work time loss category | Overallb
|
p-value | |
---|---|---|---|---|
Work time lossa
| No work time loss | |||
Total n, % | 247 (57.7) | 147 (34.3) | 428 | - |
Age at rash onset, years, mean (SD) | 59.0 (7.4) | 58.6 (7.1) | 58.9 (7. 2) | 0.674 |
Gender, female, n (%) | 126 (51.0) | 71 (48.3) | 217 (50.7) | 0.602 |
Age category at rash onset, years, n (%) | ||||
50–59 | 148 (59.9) | 95 (64.6) | 263 (61.4) | |
60–69 | 79 (32.0) | 39 (26.5) | 129 (30.1) | 0.520 |
≥ 70 | 20 (8.1) | 13 (8.8) | 35 (8.2) | |
Not Available | 0 (0.0) | 0 (0.0) | 1 (0.2) | |
Education, n (%) | ||||
Primary school or less | 54 (21.9) | 25 (17.0) | 86 (20.1) | |
High school | 77 (31.2) | 51 (34.7) | 139 (32.5) | 0.485 |
College/University | 114 (46.2) | 69 (46.9) | 199 (46.5) | |
Not Available | 2 (0.8) | 2 (1.4) | 4 (0.9) | |
Geographic region, n (%)c
| ||||
Asia | 77 (31.2) | 52 (35.4) | 140 (32.7) | |
Latin America | 91 (36.8) | 33 (22.4) | 128 (29.9) | 0.010 |
North America | 79 (32.0) | 62 (42.2) | 160 (37.4) | |
Country category (income)d
| ||||
Upper-Middle | 94 (38.1) | 42 (28.6) | 146 (34.1) | |
High | 93 (37.7) | 64 (43.5) | 171 (40.0) | 0.079 |
Not Available | 60 (24.3) | 41 (27.9) | 111 (25.9) | |
Employment status, n (%) | ||||
Full time | 200 (81.0) | 112 (76.2) | 336 (78.5) | |
Part time | 47 (19.0) | 35 (23.8) | 92 (21.5) | 0.258 |
Number of hours work overall/week | ||||
n
| 246 | 146 | 411 | |
Mean (SD) | 39.3 (16.0) | 38.3 (17.6) | 38.8 (16.5) | 0.395 |
Number of hours part time work/week | ||||
n
| 47 | 34 | 89 | |
Mean (SD) | 23.3 (11.5) | 22.9 (11.7) | 23.6 (12.2) | 0.939 |
Number of hours full time work /week | ||||
n
| 199 | 112 | 322 | |
Mean (SD) | 43.1 (14.4) | 43.0 (16.4) | 43.0 (15.0) | 0.703 |
Total number persons/household | ||||
n
| 243 | 145 | 421 | |
Mean (SD) | 2.8 (1.6) | 3.0 (1.9) | 2.8 (1.7) | 0.420 |
Type of household, n (%) | ||||
Apartment | 76 (30.8) | 48 (32.7) | 134 (31.3) | |
House | 170 (68.8) | 97 (66.0) | 291 (68.0) | 0.838 |
Other | 1 (0.4) | 1 (0.7) | 2 (0.5) | |
Not Available | 0 (0.0) | 1 (0.7) | 1 (0.2) | |
Work effectiveness, mean percent, (SD) | 50.3 (31.6) | 71.4 (27.8) | 56.0 (32.0) | <0.001 |
Work effectiveness category, n (%) | ||||
100% | 20 (8.1) | 41 (27.9) | 67 (15.7) | |
50–90% | 122 (49.4) | 71 (48.3) | 206 (48.1) | <0.001 |
10–40% | 61 (24.7) | 19 (13.0) | 87 (20.3) | |
0% | 37 (15.0) | 7 (4.8) | 10 (2.3) | |
Not Available | 7 (2.8) | 9 (6.1) | 18 (4.2) |
Variable | Work Time Loss Category | Overallb
|
p-value | |
---|---|---|---|---|
Work Time Lossa
| No Work Time Loss | |||
Total n, % | 247 (57.7) | 147 (34.3) | 428 | - |
Time from HZ onset, days | ||||
n
| 247 | 147 | 427 | |
Mean (SD) | 124.2 (458.3) | 79.6 (284.2) | 128.6 (476.6) | <0.001 |
Time from HZ onset - categorical, n (%) | ||||
Incident | 74 (30.0) | 65 (44.2) | 154 (36.0) | |
Prevalent | 173 (70.0) | 82 (55.8) | 273 (63.8) | 0.004 |
Not available | 0 (0.0) | 0 (0.0) | 1 (0.2) | |
Pain before rash appearance, n (%) | ||||
Yes | 156 (63.2) | 89 (60.5) | 260 (60.7) | |
No | 79 (32.0) | 52 (35.4) | 146 (34.1) | 0.520 |
Not available | 12 (4.9) | 6 (4.1) | 22 (5.1) | |
Average pain score before rash appearancec
| ||||
n
| 155 | 88 | 258 | |
Mean (SD) | 4.9 (2.6) | 4.4 (2.5) | 4.7 (2.6) | 0.148 |
Worst pain before rash appearancec
| ||||
n
| 154 | 86 | 255 | |
Mean (SD) | 6.4 (2.6) | 5.8 (2.5) | 6.2 (2.6) | 0.057 |
Pain since rash appearance, n (%) | ||||
Yes | 222 (89.9) | 130 (88.4) | 376 (87.9) | |
No | 14 (5.7) | 12 (8.2) | 33 (7.7) | 0.349 |
Not available | 11 (4.5) | 5 (3.4) | 19 (4.4) | |
Average pain since rash appearancec
| ||||
n
| 222 | 129 | 375 | |
Mean (SD) | 5.6 (2.3) | 4.7 (2.2) | 5.3 (2.3) | 0.002 |
Worst pain since rash appearancec
| ||||
n
| 221 | 128 | 373 | |
Mean (SD) | 7.6 (2.3) | 6.5 (2.5) | 7.2 (2.5) | <0.001 |
Pain in the last 24 hs | ||||
Yes | 224 (90.7) | 126 (85.7) | 380 (88.8) | |
No | 23 (9.3) | 20 (13.6) | 47 (11.0) | 0.178 |
Not available | 0 (0.0) | 1 (0.7) | 1 (0.2) | |
Average pain in last 24 hc
| ||||
n
| 224 | 126 | 380 | |
Mean (SD) | 4.5 (2.5) | 4.0 (2.3) | 4.3 (2.4) | 0.062 |
Worst pain in last 24 hc
| ||||
n
| 220 | 124 | 372 | |
Mean (SD) | 6.2 (2.6) | 5.4 (2.6) | 5.9 (2.6) | 0.004 |
Worst pain score category, n (%)d
| ||||
Mild | 43 (17.4) | 35 (23.8) | 83 (19.4) | |
Moderate | 91 (36.8) | 55 (37.4) | 161 (37.6) | 0.041 |
Severe | 86 (34.8) | 33 (22.4) | 127 (29.7) | |
Not available | 27 (10.9) | 24 (16.3) | 57 (13.3) | |
Severity of rash (number of lesions), n (%) | ||||
No rash | 56 (22.7) | 18 (12.2) | 84 (19.6) | |
Mild (1–20) | 107 (43.3) | 86 (58.5) | 207 (48.4) | |
Moderate (21–50) | 49 (19.8) | 24 (16.3) | 77 (18.0) | 0.014 |
Severe (>50) | 35 (14.2) | 18 (12.2) | 59 (13.8) | |
Not available | 0 (0.0) | 1 (0.7) | 1 (0.2) | |
Impaired immune statuse
| ||||
Yes | 18 (7.3) | 9 (6.1) | 29 (6.8) | |
No | 229 (92.7) | 138 (93.9) | 399 (93.2) | 0.658 |
Presence of HZ complication | ||||
Yes | 80 (32.4) | 40 (27.2) | 136 (31.8) | |
No | 166 (67.2) | 107 (72.8) | 291 (68.0) | 0.269 |
Not available | 1 (0.4) | 0 (0.0) | 1 (0.2) | |
Medication for HZ | ||||
Yes | 23 (9.3) | 24 (16.3) | 51 (11.9) | |
No | 224 (90.7) | 123 (83.7) | 377 (88.1) | 0.038 |
Variable | Baseline | Pooled visitsc
| ||||||
---|---|---|---|---|---|---|---|---|
Work time lossa
| No work time loss | Overallb
|
p-value | Work time lossa
| No work time loss | Overallb
|
p-value | |
Total nd
| 247 | 147 | 428 | - | 786 | 2148 | 3738 | |
Mobility, n (%) | ||||||||
I have no problems in walking | 174 (70.4) | 117 (79.6) | 318 (74.3) | 554 (71.9) | 1876 (89.7) | 3019 (80.9) | ||
I have some problems in walking | 65 (26.3) | 29 (19.7) | 99 (23.1) | 202 (26.2) | 184 (8.8) | 553 (14.8) | ||
I am confined to a bed | 5 (2.0) | 0 (0.0) | 5 (1.2) | 0.051 | 8 (1.0) | 4 (0.2) | 13 (0.3) | <0.001 |
Not available | 3 (1.2) | 1 (0.7) | 6 (1.4) | 7 (0.9) | 27 (1.3) | 147 (3.9) | ||
Self-care, n (%) | ||||||||
I have no problems in self-care | 191 (77.3) | 132 (89.8) | 351 (82.0) | 631 (81.8) | 1988 (95.1) | 3260 (87.4) | ||
I have some problems washing and dressing | 49 (19.8) | 13 (8.8) | 66 (15.4) | 125 (16.2) | 71 (3.4) | 310 (8.3) | ||
I am unable to wash and dress myself | 4 (1.6) | 1 (0.7) | 5 (1.2) | 0.005 | 8 (1.0) | 5 (0.2) | 15 (0.4) | <0.001 |
Not available | 3 (1.2) | 1 (0.7) | 6 (1.4) | 7 (0.9) | 27 (1.3) | 147 (3.9) | ||
Usual activities, n (%) | ||||||||
I have no problems with performing usual activities | 124 (50.2) | 102 (69.4) | 249 (58.2) | 375 (48.6) | 1773 (84.8) | 2695 (72.2) | ||
I have some problems performing usual activities | 103 (41.7) | 41 (27.9) | 153 (35.7) | 357 (46.3) | 283 (13.5) | 821 (22.0) | ||
I am unable to perform usual activities | 17 (6.9) | 3 (2.0) | 20 (4.7) | 0.001 | 32 (4.2) | 8 (0.4) | 69 (1.8) | <0.001 |
Not available | 3 (1.2) | 1 (0.7) | 6 (1.4) | 7 (0.9) | 27 (1.3) | 147 (3.9) | ||
Pain/Discomfort, n (%) | ||||||||
I have no pain or discomfort | 54 (21.9) | 45 (30.6) | 110 (25.7) | 197 (25.6) | 1379 (65.9) | 1955 (52.4) | ||
I have moderate pain or discomfort | 142 (57.5) | 84 (57.1) | 245 (57.2) | 459 (59.5) | 655 (31.3) | 1428 (38.3) | ||
I am extreme pain or discomfort | 48 (19.4) | 17 (11.6) | 67 (15.7) | 0.044 | 108 (14.0) | 30 (1.4) | 202 (5.4) | <0.001 |
Not available | 3 (1.2) | 1 (0.7) | 6 (1.4) | 7 (0.9) | 27 (1.3) | 147 (3.9) | ||
Anxiety/Depression, n (%) | ||||||||
I am not anxious or depressed | 122 (49.4) | 88 (59.9) | 230 (53.7) | 381 (49.4) | 1672 (80.0) | 512 (58.9) | ||
I am moderately anxious or depressed | 96 (38.9) | 49 (33.3) | 156 (36.4) | 325 (42.2) | 367 (17.6) | 910 (24.4) | ||
I am extremely anxious or depressed | 26 (10.5) | 9 (6.1) | 36 (8.4) | 0.097 | 58 (7.5) | 25 (1.2) | 110 (2.9) | <0.001 |
Not available | 3 (1.2) | 1 (0.7) | 27 (3.1) | 7 (0.9) | 27 (1.3) | 147 (3.9) | ||
EQ-5D summary scores based on UK weight | ||||||||
n
| 244 | 146 | 422 | 764 | 2064 | 3585 | ||
Mean (SD) | 0.6 (0.4) | 0.7 (0.3) | 0.6 (0.3) | 0.001 | 0.6 (0.3) | 0.9 (0.2) | 0.8 (0.3) | <0.001 |
VAS, mm | ||||||||
n
| 244 | 145 | 421 | 763 | 2059 | 3572 | ||
Mean (SD) | 66.7 (23.7) | 71.1 (20.5) | 68.5 (22.4) | 0.106 | 68.1 (22.6) | 86.5 (16.6) | 80.3 (21.0) | <0.001 |
Correlation analyses
Variable | Work Time Loss Category | EQ-5D item scores | Correlation coefficient b
|
P-value |
---|---|---|---|---|
Percent work effectivenessc
| Overall | Mobility | −0.265 | <0.001 |
Self-Care | −0.243 | <0.001 | ||
Usual activities | −0.401 | <0.001 | ||
Pain/Discomfort | −0.396 | <0.001 | ||
Anxiety/Depression | −0.331 | <0.001 | ||
EQ-5D summary scores based on UK weight | 0.427 | <0.001 | ||
EQ-5D VAS | 0.490 | <0.001 | ||
Mobility | −0.238 | <0.001 | ||
Self-Care | −0.158 | <0.001 | ||
Usual activities | −0.323 | <0.001 | ||
No Work Time Loss | Pain/Discomfort | −0.356 | <0.001 | |
Anxiety/Depression | −0.329 | <0.001 | ||
EQ-5D summary scores based on UK weight | 0.402 | <0.001 | ||
EQ-5D VAS | 0.511 | <0.001 | ||
Mobility | −0.148 | <0.001 | ||
Self-Care | −0.162 | <0.001 | ||
Usual activities | −0.245 | <0.001 | ||
Work Time Lossa
| Pain/Discomfort | −0.161 | <0.001 | |
Anxiety/Depression | −0.140 | <0.001 | ||
EQ-5D summary scores based on UK weight | 0.209 | <0.001 | ||
EQ-5D VAS | 0.260 | <0.001 |
Multivariate analyses
EQ-5D Item | ||||||||
---|---|---|---|---|---|---|---|---|
EQ-5D overall summary score | EQ-5D VAS | |||||||
Predictor | Estimatea
| SD | 95% CI for estimate |
p-value | Estimatea
| SD | 95% CI for estimate |
p-value |
Work Time Loss Category | ||||||||
Work Time Lossb vs. No Work Time Loss | −0.234 | 0.010 | −0.254, −0.215 | <0.001 | −16.92 | 0.755 | −18.40, −15.44 | <0.001 |
Time from HZ onset - categorical | ||||||||
Prevalent vs. incident | −0.049 | 0.014 | −0.076, −0.022 | <0.001 | −3.811 | 1.339 | −6.442, −1.181 | 0.005 |
Age category at rash onset, yearsc
| ||||||||
60–69 vs. 50–59 | −0.002 | 0.015 | −0.032, 0.028 | 0.898 | −1.562 | 1.465 | −4.441, 1.318 | 0.287 |
≥ 70 vs. 50–59 | −0.042 | 0.026 | −0.092, 0.008 | 0.100 | −2.785 | 2.472 | −7.643, 2.073 | 0.260 |
Worst Pain Categoryc,d
| ||||||||
Moderate vs. mild | −0.084 | 0.013 | −0.111, −0.058 | <0.001 | −8.842 | 1.075 | −10.95, −6.732 | <0.001 |
Severe vs. mild | −0.287 | 0.018 | −0.323, −0.251 | <0.001 | −14.08 | 1.447 | −16.92, −11.24 | <0.001 |
Severity of rash (number of lesions)c
| ||||||||
Mild (1–20) vs.no rash | 0.109 | 0.017 | 0.074, 0.143 | <0.001 | 10.646 | 1.707 | 7.292, 14.000 | <0.001 |
Moderate (21–50) vs. no rash | 0.100 | 0.021 | 0.058, 0.141 | <0.001 | 8.892 | 2.064 | 4.837, 12.947 | <0.001 |
Severe (>50) vs. no rash | 0.095 | 0.024 | 0.049, 0.142 | <0.001 | 9.684 | 2.278 | 5.207, 14.160 | <0.001 |
Genderc
| ||||||||
Male vs. female | −0.005 | 0.013 | −0.032, 0.021 | 0.691 | 0.833 | 1.295 | −1.711, 3.377 | 0.520 |
Impaired immune statusc, e
| ||||||||
Yes vs. no | −0.034 | 0.025 | −0.084, 0.016 | 0.181 | −1.876 | 2.472 | −6.734, 2.983 | 0.448 |
Presence of complications from HZc
| ||||||||
Yes vs. no | −0.012 | 0.014 | −0.040, 0.016 | 0.400 | −5.016 | 1.370 | −7.707, −2.324 | <0.001 |
Employment statusc
| ||||||||
Full time vs. part time | 0.008 | 0.016 | −0.024, 0.040 | 0.612 | −1.919 | 1.574 | −5.011, 1.173 | 0.223 |
Geographic regionc,f
| ||||||||
Latin America vs. Asia | 0.030 | 0.017 | −0.004, 0.064 | 0.191 | 3.245 | 1.628 | 0.047, 6.443 | 0.098 |
North America vs. Asia | −0.043 | 0.017 | −0.076, −0.010 | 0.011 | −5.146 | 1.583 | −8.257, −2.035 | 0.001 |
Country category (income)c, g
| ||||||||
High vs. Upper Middle | −0.052 | 0.014 | −0.079, −0.026 | <0.001 | −6.616 | 1.290 | −9.151, −4.081 | <0.001 |
EQ-5D Item | ||||||||
---|---|---|---|---|---|---|---|---|
EQ-5D overall summary scores | EQ-5D VAS | |||||||
Predictor | Estimatea
| SD | 95% CI for estimate |
p-value | Estimatea
| SD | 95% CI for estimate |
p-value |
Work Time Loss Category | ||||||||
Work Time Lossb vs. No Work Time Loss | −0.102 | 0.014 | −0.129, −0.074 | <0.001 | −6.511 | 1.109 | −8.687, −4.336 | <0.001 |
Time from HZ onset - categorical | ||||||||
Prevalent vs. incident | −0.016 | 0.019 | −0.052, 0.020 | 0.387 | −0.871 | 1.754 | −4.320, 2.578 | 0.620 |
Worst Pain Categoryc
| ||||||||
Moderate vs. mild | −0.083 | 0.014 | −0.109, −0.056 | <0.001 | −8.761 | 1.079 | −10.88, −6.643 | <0.001 |
Severe vs. mild | −0.290 | 0.018 | −0.326, −0.254 | <0.001 | −14.40 | 1.445 | −17.23, −11.56 | <0.001 |
Severity of rash (number of lesions) | ||||||||
Mild (1–20) vs. no rash | 0.044 | 0.021 | 0.002, 0.086 | 0.042 | 4.150 | 2.128 | 0.035, 8.334 | 0.052 |
Moderate (21–50) vs. no rash | 0.035 | 0.028 | −0.019, 0.090 | 0.206 | 3.755 | 2.667 | −1.489, 8.999 | 0.160 |
Severe (>50) vs. no rash | 0.070 | 0.029 | 0.012, 0.128 | 0.017 | 4.621 | 2.865 | −1.014, 10.255 | 0.108 |
Country category (income)d
| ||||||||
High vs. Upper Middle | −0.027 | 0.033 | −0.091, 0.038 | 0.413 | −8.532 | 2.902 | −14.24, −2.828 | 0.003 |
Geographic regione
| ||||||||
Latin America vs. Asia | 0.021 | 0.032 | −0.042, 0.083 | 0.513 | −2.793 | 2.839 | −8.374, 2.788 | 0.326 |
North America vs. Asia | 0.005 | 0.024 | −0.043, 0.052 | 0.851 | 1.428 | 2.253 | −3.001, 5.856 | 0.527 |
Presence of complications of HZ | ||||||||
Yes vs. no | - | - | - | - | −4.509 | 1.654 | −7.761, −1.257 | 0.007 |