Pain, medication use, and health-related quality of life in older persons with postherpetic neuralgia: Results from a population-based survey

Persons aged > 65 years with pain caused by postherpetic neuralgia (PHN) were recruited via advertisements in 24 US newspapers and were mailed a questionnaire that addressed pain intensity (average, worst, least, current), pain interference (with general activity, mood, relations with other people, sleep, enjoyment of life), and health-related quality of life (using the EuroQoL health measure [EQ-5D] and a global rating scale). Respondents also were asked about their use of medication for shingles pain. A total of 385 persons completed the survey; 61% were > 75 years of age. Mean (+/- standard deviation) duration of PHN was 3.3 (+/- 4.0) years. Only about one half had taken prescription medication for shingles pain during the prior week; dosages were typically low. Mean average, worst, least, and current pain caused by shingles (0- to 10-point scale) was 4.6 ( +/- 2.1), 6.0 ( +/- 2.4), 2.9 (+/- 2.3), and 4.0 ( +/- 2.7), respectively. Mean pain interference with general activity, mood, relations with other people, sleep, and enjoyment of life (0- to 10-point scale) was 3.7 ( +/- 3.1), 4.3 ( +/- 2.9), 3.0 ( +/- 2.8), 3.8 ( +/- 2.9), and 4.5 ( +/- 3.1), respectively. The mean EQ-5D health index score was 0.61; respondents rated their overall health as 65.7 ( +/- 21.1) on a 100-point scale. PHN causes substantial pain, dysfunction, and poor health-related quality of life in older persons, many of whom might be suboptimally treated. Perspective: many older persons (age > 65 years) with PHN experience longstanding, severe, and debilitating pain and poor health-related quality of life, levels of dissatisfaction with treatment are high. Our study highlights the need for improved management of this disease. (c) 2005 by the American Pain Society.