Impact of Herpes Zoster Ophthalmicus on Healthcare Utilization and Patient Reported Outcomes: Results from a Multicenter Cohort Study
Author(s)
Laura T. Pizzi, PharmD, MPH1, Benjamin E. Leiby, PhD2, Ayako Shimada, MS2, David Chu, MD3, Herbert J. Ingraham, MD4, Emily W. Gower, PhD5, Joseph P. Shovlin, OD, FAAO6, Beth R. Friedland, MD7, Haresh Ailani, MD8, Katherine M. Prioli, MS1, Kejsi Begaj, PharmD, MS1, Alin Kalayjian, PharmD, MBA1, Justin D. Gatwood, PhD, MPH9, Ann P. Murchison, MD, MPH10;
1Rutgers University, Piscataway, NJ, USA, 2Thomas Jefferson University, Philadelphia, PA, USA, 3Metropolitan Eye Research and Surgery Institute, Palisades Park, NJ, USA, 4Geisinger Health System, Danville, PA, USA, 5Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 6Northeastern Eye Institute, Scranton, PA, USA, 7University of North Carolina Chapel Hill School of Medicine, Chapel Hill, NC, USA, 8Eye Consultants of Northern Virginia, Springfield, VA, USA, 9GSK, Philadelphia, PA, USA, 10Wills Eye Hospital, Philadelphia, PA, USA
1Rutgers University, Piscataway, NJ, USA, 2Thomas Jefferson University, Philadelphia, PA, USA, 3Metropolitan Eye Research and Surgery Institute, Palisades Park, NJ, USA, 4Geisinger Health System, Danville, PA, USA, 5Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 6Northeastern Eye Institute, Scranton, PA, USA, 7University of North Carolina Chapel Hill School of Medicine, Chapel Hill, NC, USA, 8Eye Consultants of Northern Virginia, Springfield, VA, USA, 9GSK, Philadelphia, PA, USA, 10Wills Eye Hospital, Philadelphia, PA, USA
Presentation Documents
OBJECTIVES: This prospective cohort study measured the burden of herpes zoster ophthalmicus (HZO) at 6 United States ophthalmology practices from 2019-2024.
METHODS: English/Spanish-speaking patients aged ≥18 years with active HZO, not enrolled in a concurrent HZO trial, were recruited after physician evaluation. Data were collected at 4 time points (T=0, 3, 6, 12 months), included clinical assessment, patient questionnaires on symptoms, healthcare utilization, and outcomes using validated instruments: National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) for vision-related quality of life; Patient Health Questionnaire (PHQ-8) for depressive symptoms; Zoster Brief Pain Inventory (ZBPI) for pain; and Work Productivity and Activity Impairment-Specific Health Problem (WPAI-SHP) for productivity (among those working). Descriptive statistics and generalized linear mixed models examined changes in outcomes over time for PHQ-8 and healthcare utilization.
RESULTS: A total of 129 HZO patients (mean age=63.9 years, SD=14.1) completed the clinical assessment (34.5% localized deep pain; 32.7% redness; 30.0% periorbital rash; 24.5% localized burning, 23.6% localized itching, 21.8% active blistering, 9.1% healing blisters). The baseline survey was completed by 104 patients (66.4% white, 59.6% female, 28.8% shingles-vaccinated). Mean NEI-VFQ-25 score improved from 81.6 (SD=15.9) at baseline to 85.9 (SD=12.9) at 12 months. Average worst pain ZBPI score decreased from 1.6 (SD=2.7) at baseline to 0.9 (SD=2.1) at 12 months. Work productivity loss decreased from 16.6% (N=44, SD=23.7) at baseline to 8.8% (N=40, SD=17.1) at 12 months. HZO-related healthcare utilization, with a recall period of 3 months, was high at baseline with 89.4% reporting outpatient visits and 31.7% reporting emergency room or urgent care visits, but decreased to 67.8% (p=0.037) and 12.2% (p=0.004) at 12 months, respectively. Mean PHQ-8 score improved from 4.6 (SD=5.0) at baseline to 2.7 (SD=3.2) at 12 months (p=0.028).
CONCLUSIONS: These findings highlight the importance of assessing the HZO burden on patients to best manage its impact and associated healthcare utilization.
METHODS: English/Spanish-speaking patients aged ≥18 years with active HZO, not enrolled in a concurrent HZO trial, were recruited after physician evaluation. Data were collected at 4 time points (T=0, 3, 6, 12 months), included clinical assessment, patient questionnaires on symptoms, healthcare utilization, and outcomes using validated instruments: National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) for vision-related quality of life; Patient Health Questionnaire (PHQ-8) for depressive symptoms; Zoster Brief Pain Inventory (ZBPI) for pain; and Work Productivity and Activity Impairment-Specific Health Problem (WPAI-SHP) for productivity (among those working). Descriptive statistics and generalized linear mixed models examined changes in outcomes over time for PHQ-8 and healthcare utilization.
RESULTS: A total of 129 HZO patients (mean age=63.9 years, SD=14.1) completed the clinical assessment (34.5% localized deep pain; 32.7% redness; 30.0% periorbital rash; 24.5% localized burning, 23.6% localized itching, 21.8% active blistering, 9.1% healing blisters). The baseline survey was completed by 104 patients (66.4% white, 59.6% female, 28.8% shingles-vaccinated). Mean NEI-VFQ-25 score improved from 81.6 (SD=15.9) at baseline to 85.9 (SD=12.9) at 12 months. Average worst pain ZBPI score decreased from 1.6 (SD=2.7) at baseline to 0.9 (SD=2.1) at 12 months. Work productivity loss decreased from 16.6% (N=44, SD=23.7) at baseline to 8.8% (N=40, SD=17.1) at 12 months. HZO-related healthcare utilization, with a recall period of 3 months, was high at baseline with 89.4% reporting outpatient visits and 31.7% reporting emergency room or urgent care visits, but decreased to 67.8% (p=0.037) and 12.2% (p=0.004) at 12 months, respectively. Mean PHQ-8 score improved from 4.6 (SD=5.0) at baseline to 2.7 (SD=3.2) at 12 months (p=0.028).
CONCLUSIONS: These findings highlight the importance of assessing the HZO burden on patients to best manage its impact and associated healthcare utilization.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
PCR24
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
SDC: Infectious Disease (non-vaccine), SDC: Sensory System Disorders (Ear, Eye, Dental, Skin)