Rampakakis Emmanouil, Stutz Melissa, Kawai Kosuke, Tsai Tsen-Fang, Cheong Hee Jin, Dhitavat Jittima, Ortiz-Covarrubias Alejandro, Cashat-Cruz Miguel, Monsanto Homero, Johnson Kelly D, Sampalis John S, Acosta Camilo J
JSS Medical Research, 9400 Henri-Bourassa W, St-Laurent, QC, H4S 1N8, Canada.
Clinical Research Center, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave., Boston, MA, 02115, USA.
Health Qual Life Outcomes. 2017 Jan 18;15(1):11. doi: 10.1186/s12955-017-0588-x.
Herpes zoster (HZ) has a significant negative effect on the productive work life of individuals, and has been shown to be responsible for cases of absenteeism, presenteeism and decreased work effectiveness. The aim of this study was to evaluate health utility scores and associated predictors in an actively employed population of Herpes Zoster (HZ) patients with and without work time loss (WTL).
This was a pooled analysis of the prospective, observational MASTER cohort studies, conducted in 8 countries across North America, Latin America and Asia. A total of 428 HZ patients engaged in full or part time work were included. WTL, defined as missing ≥ 1 partial or full work day, and work effectiveness, reported on a scale of 0-100%, were evaluated with the Work and Productivity Questionnaire (WPQ). The Pearson product-moment correlation was used to assess the correlation between work effectiveness and HRQoL. Mixed models with repeated measures assessed the relationship between HZ-related WTL over a 6-month follow-up period, and HRQoL, as evaluated by the EQ-5D. Additional predictors of HRQoL were also identified.
Overall, 57.7% of respondents reported WTL. Mean (SD) percent work effectiveness of patients in the WTL group was significantly lower compared to non-WTL (NWTL) patients at baseline [50.3 (31.6) vs. 71.4 (27.8); p < 0.001]. Patients in the WTL group also reported lower health utility scores at baseline and overall than their NWTL counterparts, with WTL identified as an independent negative predictor of both the EQ-5D summary scores and the EQ-5D VAS (p < 0.001). Decrease in work effectiveness was negatively associated with HRQoL overall (p < 0.001). Predictors of lower HRQoL were worst Zoster Brief Pain Inventory (ZBPI) pain score, the presence of HZ complications and country income (predictor of EQ-5D VAS only).
HZ adversely impacts the work and productive life of actively employed individuals. In turn, HZ-related reductions in work effectiveness and work time are associated with a negative effect on HRQoL.
带状疱疹（HZ）对个体的生产性生活有显著负面影响，且已被证明是旷工、出勤但生产力低下及工作效率下降等情况的原因。本研究的目的是评估有工作时间损失（WTL）和无工作时间损失的在职带状疱疹（HZ）患者群体的健康效用得分及相关预测因素。
这是一项对在北美、拉丁美洲和亚洲8个国家进行的前瞻性观察性MASTER队列研究的汇总分析。共纳入428名从事全职或兼职工作的HZ患者。工作时间损失定义为缺勤≥1个工作日或完整工作日，工作效率通过工作与生产力问卷（WPQ）以0 - 100%的量表进行报告。使用Pearson积矩相关系数评估工作效率与健康相关生活质量（HRQoL）之间的相关性。采用重复测量的混合模型评估在6个月随访期内HZ相关的工作时间损失与通过EQ - 5D评估的HRQoL之间的关系。还确定了HRQoL的其他预测因素。
总体而言，57.7%的受访者报告有工作时间损失。在基线时，工作时间损失组患者的平均（标准差）工作效率百分比显著低于无工作时间损失（NWTL）组患者[50.3（31.6）对71.4（27.8）；p < 0.001]。工作时间损失组患者在基线时及总体上报告的健康效用得分也低于无工作时间损失组患者，工作时间损失被确定为EQ - 5D汇总得分和EQ - 5D视觉模拟量表（VAS）的独立负面预测因素（p < 0.001）。工作效率下降与总体HRQoL呈负相关（p < 0.001）。较低HRQoL的预测因素包括带状疱疹简短疼痛量表（ZBPI）最差疼痛评分、HZ并发症的存在以及国家收入（仅为EQ - 5D VAS的预测因素）。
HZ对在职个体的工作和生产性生活有不利影响。反过来，HZ相关的工作效率和工作时间减少对HRQoL有负面影响。
