Skip to main content
Top
Published in: BMC Primary Care 1/2011

Open Access 01-12-2011 | Research article

Measuring the burden of herpes zoster and post herpetic neuralgia within primary care in rural Crete, Greece

Authors: Christos D Lionis, Constantine I Vardavas, Emmanouil K Symvoulakis, Maria G Papadakaki, Foteini S Anastasiou, Maria D Antonopoulou, Charalampos M Apostolakis, Stelios A Dimitrakopoulos, George I Fountakis, Ilias A Grammatikopoulos, John D Komninos, Dimitris K Kounalakis, Eva S Ladoukaki, Kornilia V Makri, Chrysa S Petraki, Nikos G Ploumis, Dimitra P Prokopiadou, Ioanna N Stefanaki, Nikos A Tsakountakis, Ioanna G Tsiligianni, Emmanouil N Tzortzis, Aggeliki A Vasilaki, Theodoros K Vasilopoulos, George E Vrentzos

Published in: BMC Primary Care | Issue 1/2011

Login to get access

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.
Literature
1.
go back to reference Stein AN, Britt H, Harrison C, Conway EL, Cunningham A, Macintyre CR: Herpes zoster burden of illness and health care resource utilisation in the Australian population aged 50 years and older. Vaccine. 2009, 27: 520-9.CrossRefPubMed Stein AN, Britt H, Harrison C, Conway EL, Cunningham A, Macintyre CR: Herpes zoster burden of illness and health care resource utilisation in the Australian population aged 50 years and older. Vaccine. 2009, 27: 520-9.CrossRefPubMed
2.
go back to reference Insinga RP, Itzler RF, Pellissier JM, Saddier P, Nikas AA: The incidence of herpes zoster in a United States administrative database. J Gen Intern Med. 2005, 20: 748-753.CrossRefPubMedPubMedCentral Insinga RP, Itzler RF, Pellissier JM, Saddier P, Nikas AA: The incidence of herpes zoster in a United States administrative database. J Gen Intern Med. 2005, 20: 748-753.CrossRefPubMedPubMedCentral
3.
go back to reference Opstelten W, Mauritz JW, de Wit NJ, van Wijck AJ, Stalman WA, van Essen GA: Herpes zoster and postherpetic neuralgia: incidence and risk indicators using a general practice research database. Fam Pract. 2002, 19: 471-475.CrossRefPubMed Opstelten W, Mauritz JW, de Wit NJ, van Wijck AJ, Stalman WA, van Essen GA: Herpes zoster and postherpetic neuralgia: incidence and risk indicators using a general practice research database. Fam Pract. 2002, 19: 471-475.CrossRefPubMed
4.
go back to reference Tyring SK: Management of herpes zoster and postherpetic neuralgia. J Am Acad Dermatol. 2007, 57 (Suppl 6): S136-42.CrossRefPubMed Tyring SK: Management of herpes zoster and postherpetic neuralgia. J Am Acad Dermatol. 2007, 57 (Suppl 6): S136-42.CrossRefPubMed
5.
go back to reference Katz J, Cooper EM, Walther RR, Sweeney EW, Dworkin RH: Acute pain in herpes zoster and its impact on health-related quality of life. Clin Infect Dis. 2004, 39: 342-348.CrossRefPubMed Katz J, Cooper EM, Walther RR, Sweeney EW, Dworkin RH: Acute pain in herpes zoster and its impact on health-related quality of life. Clin Infect Dis. 2004, 39: 342-348.CrossRefPubMed
6.
go back to reference Kost RG, Straus SE: Postherpetic neuralgia-pathogenesis, treatment and prevention. N Eng J Med. 1996, 335: 32-42.CrossRef Kost RG, Straus SE: Postherpetic neuralgia-pathogenesis, treatment and prevention. N Eng J Med. 1996, 335: 32-42.CrossRef
7.
go back to reference McElhaney JE: Herpes zoster: a common disease that can have a devastating impact on patients' quality of life. Expert Rev Vaccines. 2010, 9: 27-30.CrossRefPubMed McElhaney JE: Herpes zoster: a common disease that can have a devastating impact on patients' quality of life. Expert Rev Vaccines. 2010, 9: 27-30.CrossRefPubMed
8.
go back to reference Johnson RW: Consequences and management of pain in herpes zoster. J Infect Dis. 2002, 186: S83-S90.CrossRefPubMed Johnson RW: Consequences and management of pain in herpes zoster. J Infect Dis. 2002, 186: S83-S90.CrossRefPubMed
9.
go back to reference Brisson M, Edmunds WJ, Gay NJ: Varicella vaccination: impact of vaccine efficacy on the epidemiology of VZV. J Med Virol. 2003, 70: S31-S37.CrossRefPubMed Brisson M, Edmunds WJ, Gay NJ: Varicella vaccination: impact of vaccine efficacy on the epidemiology of VZV. J Med Virol. 2003, 70: S31-S37.CrossRefPubMed
10.
go back to reference Schuette MC, Hethcote HW: Modeling the effects of varicella vaccination programs on the incidence of chickenpox and shingles. Bull Math Biol. 1999, 61: 1031-1064.CrossRefPubMed Schuette MC, Hethcote HW: Modeling the effects of varicella vaccination programs on the incidence of chickenpox and shingles. Bull Math Biol. 1999, 61: 1031-1064.CrossRefPubMed
12.
go back to reference Markman JD, Dukes E, Siffert J, Griesing T: Patient flow in neuropathic pain management: understanding existing patterns of care [Abstract]. Eur J Neurol. 2004, 11 (Suppl 2): 135-6. Markman JD, Dukes E, Siffert J, Griesing T: Patient flow in neuropathic pain management: understanding existing patterns of care [Abstract]. Eur J Neurol. 2004, 11 (Suppl 2): 135-6.
13.
go back to reference Truyers C, Lesaffre E, Bartholomeeusen S, Aertgeerts B, Snacken R, Brochier B, Yane F, Buntinx F: Computerized general practice based networks yield comparable performance with sentinel data in monitoring epidemiological time-course of influenza-like illness and acute respiratory illness. BMC Fam Pract. 2010, 11: 24-CrossRefPubMedPubMedCentral Truyers C, Lesaffre E, Bartholomeeusen S, Aertgeerts B, Snacken R, Brochier B, Yane F, Buntinx F: Computerized general practice based networks yield comparable performance with sentinel data in monitoring epidemiological time-course of influenza-like illness and acute respiratory illness. BMC Fam Pract. 2010, 11: 24-CrossRefPubMedPubMedCentral
14.
go back to reference Grammatikopoulos IA, Sinoff G, Alegakis A, Kounalakis D, Antonopoulou M, Lionis C: The Short Anxiety Screening Test in Greek: translation and validation. Ann Gen Psychiatry. 2010. Grammatikopoulos IA, Sinoff G, Alegakis A, Kounalakis D, Antonopoulou M, Lionis C: The Short Anxiety Screening Test in Greek: translation and validation. Ann Gen Psychiatry. 2010.
15.
go back to reference Thomas SL, Hall AJ: What does epidemiology tell us about risk factors for herpes zoster?. Lancet Infect Dis. 2004, 4: 26-33.CrossRefPubMed Thomas SL, Hall AJ: What does epidemiology tell us about risk factors for herpes zoster?. Lancet Infect Dis. 2004, 4: 26-33.CrossRefPubMed
16.
17.
go back to reference Ragozzino MW, Melton LJ, Kurland LT, Chu CP, Perry HO: Population-based study of herpes zoster and its sequelae. Medicine (Baltimore). 1982, 61: 310-6.CrossRef Ragozzino MW, Melton LJ, Kurland LT, Chu CP, Perry HO: Population-based study of herpes zoster and its sequelae. Medicine (Baltimore). 1982, 61: 310-6.CrossRef
18.
go back to reference Chidiac C, Bruxelle J, Daures JP, Hoang-Xuan T, Morel P, Lepiege A, El Hasnaoui A, de Lebareyre C: Characteristics of patients with herpes zoster on presentation to practitioners in France. Clin Infect Dis. 2001, 33: 62-9.CrossRefPubMed Chidiac C, Bruxelle J, Daures JP, Hoang-Xuan T, Morel P, Lepiege A, El Hasnaoui A, de Lebareyre C: Characteristics of patients with herpes zoster on presentation to practitioners in France. Clin Infect Dis. 2001, 33: 62-9.CrossRefPubMed
19.
go back to reference Lionis C, Symvoulakis EK, Vardavas CI: Implementing family practice research in countries with limited resources: a stepwise model experienced in Crete, Greece. Fam Pract. 2010, 27: 48-54.CrossRefPubMed Lionis C, Symvoulakis EK, Vardavas CI: Implementing family practice research in countries with limited resources: a stepwise model experienced in Crete, Greece. Fam Pract. 2010, 27: 48-54.CrossRefPubMed
20.
go back to reference Fleming DM, Bartelds A, Chapman RS, Cross KW: The consistency of shingles and its significance for health monitoring. Eur J Epidemiol. 2004, 19: 1113-8.CrossRefPubMed Fleming DM, Bartelds A, Chapman RS, Cross KW: The consistency of shingles and its significance for health monitoring. Eur J Epidemiol. 2004, 19: 1113-8.CrossRefPubMed
21.
go back to reference Dworkin R, Hartstein G, Rosner H, Walther RR, Sweeney E, Brand L: A high-risk method for studying psychosocial antecedents of chronic pain: the prospective investigation of herpes zoster. J Abnorm Psychol. 1992, 101: 200-5.CrossRefPubMed Dworkin R, Hartstein G, Rosner H, Walther RR, Sweeney E, Brand L: A high-risk method for studying psychosocial antecedents of chronic pain: the prospective investigation of herpes zoster. J Abnorm Psychol. 1992, 101: 200-5.CrossRefPubMed
22.
go back to reference Engberg IB, Grondahl G, Thibom K: Patients' experiences of herpes zoster and postherpetic neuralgia. J Adv Nurs. 1995, 21: 427-433.CrossRefPubMed Engberg IB, Grondahl G, Thibom K: Patients' experiences of herpes zoster and postherpetic neuralgia. J Adv Nurs. 1995, 21: 427-433.CrossRefPubMed
23.
go back to reference Katz J, McDermott MP, Cooper EM, Walther RR, Sweeney EW, Dworkin RH: Psychosocial risk factors for postherpetic neuralgia: a prospective study of patients with herpes zoster. J Pain. 2005, 6: 782-90.CrossRefPubMed Katz J, McDermott MP, Cooper EM, Walther RR, Sweeney EW, Dworkin RH: Psychosocial risk factors for postherpetic neuralgia: a prospective study of patients with herpes zoster. J Pain. 2005, 6: 782-90.CrossRefPubMed
24.
go back to reference Pellissier JM, Brisson M, Levin MJ: Evaluation of the cost-effectiveness in the United States of a vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. Vaccine. 2007, 25: 8326-37.CrossRefPubMed Pellissier JM, Brisson M, Levin MJ: Evaluation of the cost-effectiveness in the United States of a vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. Vaccine. 2007, 25: 8326-37.CrossRefPubMed
25.
go back to reference White RR, Lenhart G, Singhal PK, Insinga RP, Itzler RF, Pellissier JM, Segraves AW: Incremental 1-year medical resource utilization and costs for patients with herpes zoster from a set of US health plans. Pharmacoeconomics. 2009, 27: 781-92.CrossRefPubMed White RR, Lenhart G, Singhal PK, Insinga RP, Itzler RF, Pellissier JM, Segraves AW: Incremental 1-year medical resource utilization and costs for patients with herpes zoster from a set of US health plans. Pharmacoeconomics. 2009, 27: 781-92.CrossRefPubMed
26.
go back to reference Plotkin SA, Starr SE, Connor K, Morton D: Zoster in normal children after varicella vaccine. J Infect Dis. 1989, 159: 1000-1.CrossRefPubMed Plotkin SA, Starr SE, Connor K, Morton D: Zoster in normal children after varicella vaccine. J Infect Dis. 1989, 159: 1000-1.CrossRefPubMed
27.
go back to reference Gershon A, Silverstein S: Live attenuated vaccine varicella vaccine for prevention of herpes zoster. Biologicals. 1997, 25: 227-30.CrossRefPubMed Gershon A, Silverstein S: Live attenuated vaccine varicella vaccine for prevention of herpes zoster. Biologicals. 1997, 25: 227-30.CrossRefPubMed
28.
go back to reference Dworkin RH, White R, O'Connor AB, Baser O, Hawkins K: Healthcare costs of acute and chronic pain associated with a diagnosis of herpes zoster. J Am Geriatr Soc. 2007, 55: 1168-75.CrossRefPubMed Dworkin RH, White R, O'Connor AB, Baser O, Hawkins K: Healthcare costs of acute and chronic pain associated with a diagnosis of herpes zoster. J Am Geriatr Soc. 2007, 55: 1168-75.CrossRefPubMed
29.
go back to reference Dworkin RH, White R, O'Connor AB, Hawkins K: Health care expenditure burden of persisting herpes zoster pain. Pain Med. 2008, 9: 348-53.CrossRefPubMed Dworkin RH, White R, O'Connor AB, Hawkins K: Health care expenditure burden of persisting herpes zoster pain. Pain Med. 2008, 9: 348-53.CrossRefPubMed
30.
go back to reference Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD, Arbeit RD, Simberkoff MS, Gershon AA, Davis LE, Weinberg A, Boardman KD, Williams HM, Zhang JH, Peduzzi PN, Beisel CE, Morrison VA, Guatelli JC, Brooks PA, Kauffman CA, Pachucki CT, Neuzil KM, Betts RF, Wright PF, Griffin MR, Brunell P, Soto NE, Marques AR, Keay SK, Goodman RP, et al: Shingles Prevention Study Group. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med. 2005, 352: 2271-84.CrossRefPubMed Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD, Arbeit RD, Simberkoff MS, Gershon AA, Davis LE, Weinberg A, Boardman KD, Williams HM, Zhang JH, Peduzzi PN, Beisel CE, Morrison VA, Guatelli JC, Brooks PA, Kauffman CA, Pachucki CT, Neuzil KM, Betts RF, Wright PF, Griffin MR, Brunell P, Soto NE, Marques AR, Keay SK, Goodman RP, et al: Shingles Prevention Study Group. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med. 2005, 352: 2271-84.CrossRefPubMed
31.
go back to reference Opstelten W, van Loon AM, Schuller M, van Wijck AJ, van Essen GA, Moons KG, Verheij TJ: Clinical diagnosis of herpes zoster in family practice. Ann Fam Med. 2007, 5: 305-9.CrossRefPubMedPubMedCentral Opstelten W, van Loon AM, Schuller M, van Wijck AJ, van Essen GA, Moons KG, Verheij TJ: Clinical diagnosis of herpes zoster in family practice. Ann Fam Med. 2007, 5: 305-9.CrossRefPubMedPubMedCentral
32.
go back to reference Opstelten W, Zuithoff NP, van Essen GA, van Loon AM, van Wijck AJ, Kalkman CJ, Verheij TJ, Moons KG: Predicting postherpetic neuralgia in elderly primary care patients with herpes zoster: prospective prognostic study. Pain. 2007, 132 (Suppl 1): S52-9.CrossRefPubMed Opstelten W, Zuithoff NP, van Essen GA, van Loon AM, van Wijck AJ, Kalkman CJ, Verheij TJ, Moons KG: Predicting postherpetic neuralgia in elderly primary care patients with herpes zoster: prospective prognostic study. Pain. 2007, 132 (Suppl 1): S52-9.CrossRefPubMed
Metadata
Title
Measuring the burden of herpes zoster and post herpetic neuralgia within primary care in rural Crete, Greece
Authors
Christos D Lionis
Constantine I Vardavas
Emmanouil K Symvoulakis
Maria G Papadakaki
Foteini S Anastasiou
Maria D Antonopoulou
Charalampos M Apostolakis
Stelios A Dimitrakopoulos
George I Fountakis
Ilias A Grammatikopoulos
John D Komninos
Dimitris K Kounalakis
Eva S Ladoukaki
Kornilia V Makri
Chrysa S Petraki
Nikos G Ploumis
Dimitra P Prokopiadou
Ioanna N Stefanaki
Nikos A Tsakountakis
Ioanna G Tsiligianni
Emmanouil N Tzortzis
Aggeliki A Vasilaki
Theodoros K Vasilopoulos
George E Vrentzos
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2011
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-12-136

Other articles of this Issue 1/2011

BMC Primary Care 1/2011 Go to the issue