Health resource use and epidemiologic profile of herpes zoster outpatients aged 50 years or older: a modified Delphi consensus panel in Brazil

Herpes Zoster (HZ) and its complications, such as Postherpetic Neuralgia (PHN), are associated with significant burden in elderly. In Brazil, data on economic and epidemiologic HZ burden is still limited. We conducted a Delphi panel to assess healthcare resource use in HZ outpatients aged 50-years a...

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Main Authors: Ângela Maria Bagattini, Michelle Quarti Machado da Rosa, Jorge A. Gomez, Jamile Ballivian, Agustín Casarini, Ariel Bardach, Cristiana Maria Toscano
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Brazilian Journal of Infectious Diseases
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Online Access:http://www.sciencedirect.com/science/article/pii/S1413867025000613
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author Ângela Maria Bagattini
Michelle Quarti Machado da Rosa
Jorge A. Gomez
Jamile Ballivian
Agustín Casarini
Ariel Bardach
Cristiana Maria Toscano
author_facet Ângela Maria Bagattini
Michelle Quarti Machado da Rosa
Jorge A. Gomez
Jamile Ballivian
Agustín Casarini
Ariel Bardach
Cristiana Maria Toscano
author_sort Ângela Maria Bagattini
collection DOAJ
description Herpes Zoster (HZ) and its complications, such as Postherpetic Neuralgia (PHN), are associated with significant burden in elderly. In Brazil, data on economic and epidemiologic HZ burden is still limited. We conducted a Delphi panel to assess healthcare resource use in HZ outpatients aged 50-years and older. Diagnosis and treatment resources, proportion of referral and hospitalization were estimated considering HZ, PHN, ophthalmic and neurologic zoster typical cases. A diverse group of 20 medical specialists was selected, and responded anonymously to an online questionnaire. Consensus was met if ≥ 75 % agreement was reached in the 1st round, and if not met, a 2nd round was held. Summary statistics are reported stratified by age-groups and healthcare system (public and private). Responses were obtained from 19 and 17 panel members in the 1st and 2nd rounds, respectively. The proportion HZ outpatients with PHN increased significantly with age (4 % in 50‒59; 14 % in ≥ 80 years). Ophtalmic and neurological complications ranged from 5 %‒13 % across age groups. Absenteeism was high, ranging from 30 %‒68 % of patients depending on the clinical presentation. HZ patients required 2‒3 medical visits, and referral to another medical specialty varied from 10 %‒22 % across age ranges, doubling for NPH patients. Proportion of hospitalization varied from 1–8 %. HZ diagnosis was mainly clinical (93 %). Acyclovir (95 %) and valaciclovir (80 %) were the therapy of choice in the public and private systems, respectively. Pain management included dipyrone and codeine (63 %), pregabalin (58 %), and gabapentin (Neurontin) (48 %). Our results report significant healthcare resource utilization by elderly HZ patients in Brazil.
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spelling doaj-art-0665b081a71546cd9dcd2bccb6ad37812025-08-20T03:30:20ZengElsevierBrazilian Journal of Infectious Diseases1413-86702025-09-0129510456010.1016/j.bjid.2025.104560Health resource use and epidemiologic profile of herpes zoster outpatients aged 50 years or older: a modified Delphi consensus panel in BrazilÂngela Maria Bagattini0Michelle Quarti Machado da Rosa1Jorge A. Gomez2Jamile Ballivian3Agustín Casarini4Ariel Bardach5Cristiana Maria Toscano6Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Goiânia, GO, Brazil; Corresponding author.Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Goiânia, GO, BrazilValue Evidence & Outcomes, GSK Vaccines, Emerging Markets, Av. del Libertador 7208, CABA C1429BMS, ArgentinaInstitute for Clinical Effectiveness and Health Policy, ArgentinaInstitute for Clinical Effectiveness and Health Policy, ArgentinaInstitute for Clinical Effectiveness and Health Policy, Argentina; Center for Research in Epidemiology and Public Health, CONICET, ArgentinaUniversidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Goiânia, GO, BrazilHerpes Zoster (HZ) and its complications, such as Postherpetic Neuralgia (PHN), are associated with significant burden in elderly. In Brazil, data on economic and epidemiologic HZ burden is still limited. We conducted a Delphi panel to assess healthcare resource use in HZ outpatients aged 50-years and older. Diagnosis and treatment resources, proportion of referral and hospitalization were estimated considering HZ, PHN, ophthalmic and neurologic zoster typical cases. A diverse group of 20 medical specialists was selected, and responded anonymously to an online questionnaire. Consensus was met if ≥ 75 % agreement was reached in the 1st round, and if not met, a 2nd round was held. Summary statistics are reported stratified by age-groups and healthcare system (public and private). Responses were obtained from 19 and 17 panel members in the 1st and 2nd rounds, respectively. The proportion HZ outpatients with PHN increased significantly with age (4 % in 50‒59; 14 % in ≥ 80 years). Ophtalmic and neurological complications ranged from 5 %‒13 % across age groups. Absenteeism was high, ranging from 30 %‒68 % of patients depending on the clinical presentation. HZ patients required 2‒3 medical visits, and referral to another medical specialty varied from 10 %‒22 % across age ranges, doubling for NPH patients. Proportion of hospitalization varied from 1–8 %. HZ diagnosis was mainly clinical (93 %). Acyclovir (95 %) and valaciclovir (80 %) were the therapy of choice in the public and private systems, respectively. Pain management included dipyrone and codeine (63 %), pregabalin (58 %), and gabapentin (Neurontin) (48 %). Our results report significant healthcare resource utilization by elderly HZ patients in Brazil.http://www.sciencedirect.com/science/article/pii/S1413867025000613Herpes zosterPost-herpetic neuralgiaHealthcare resourceEpidemiology
spellingShingle Ângela Maria Bagattini
Michelle Quarti Machado da Rosa
Jorge A. Gomez
Jamile Ballivian
Agustín Casarini
Ariel Bardach
Cristiana Maria Toscano
Health resource use and epidemiologic profile of herpes zoster outpatients aged 50 years or older: a modified Delphi consensus panel in Brazil
Brazilian Journal of Infectious Diseases
Herpes zoster
Post-herpetic neuralgia
Healthcare resource
Epidemiology
title Health resource use and epidemiologic profile of herpes zoster outpatients aged 50 years or older: a modified Delphi consensus panel in Brazil
title_full Health resource use and epidemiologic profile of herpes zoster outpatients aged 50 years or older: a modified Delphi consensus panel in Brazil
title_fullStr Health resource use and epidemiologic profile of herpes zoster outpatients aged 50 years or older: a modified Delphi consensus panel in Brazil
title_full_unstemmed Health resource use and epidemiologic profile of herpes zoster outpatients aged 50 years or older: a modified Delphi consensus panel in Brazil
title_short Health resource use and epidemiologic profile of herpes zoster outpatients aged 50 years or older: a modified Delphi consensus panel in Brazil
title_sort health resource use and epidemiologic profile of herpes zoster outpatients aged 50 years or older a modified delphi consensus panel in brazil
topic Herpes zoster
Post-herpetic neuralgia
Healthcare resource
Epidemiology
url http://www.sciencedirect.com/science/article/pii/S1413867025000613
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