The impact of and subsequent chronic pain on patients' daily lives

Abstract

Aim: The aim of our study was to carry out a literature review and develop a model illustrating the domains of patients' lives that are impacted by herpes zoster (HZ) and subsequent chronic pain. Subjects and methods: Biomedical databases and online congress archives were searched using keywords related to HZ or post-herpetic neuralgia (PHN) and social, psychological or physical impact. A total of 733 abstracts were reviewed, and 29 publications containing concepts reported by patients were retained for the model. Wilson and Cleary’s model was used to organise the findings. Links between concepts were documented on three levels: hypothesis, observation and evidence. The final model illustrates the concepts impacted by HZ and PHN, relationships between these concepts and the level of evidence identified. Results: The concepts identified from the articles were grouped into the following categories: biological/ physiological, symptom status, functional status, health perceptions, characteristics of the individual, health-related quality of life (HRQOL), treatment and characteristics of the environment. Evidence exists showing that HZ-related pain directly impacts functional status, health perceptions and HRQOL. Conclusion: Patients report that all major domains of life are impaired by HZ or subsequent chronic pain. HZ and its painful and debilitating complications can have a substantial impact on physical, psychological, social and role functioning, HRQOL and activities of daily living. The impact on elderly patients needs to be further assessed with appropriately designed and validated instruments, with specific attention paid to dependence.