Validation of a Herpes Zoster Conceptual Model on Quality of Life in East Asia

This cross-sectional concept elicitation study aimed to evaluate herpes zoster (HZ) and postherpetic neuralgia (PHN) impact on health-related quality of life (HRQoL) in patients aged ≥50 years in East Asia, in relation to local cultural/contextual factors, and qualitatively validate a published Canadian conceptual model.

One-to-one semi-structured interviews were conducted among HZ/PHN patients aged ≥50 years in selected East Asia locales (Hong Kong/Mainland China/South Korea/Taiwan) in September 2022 to February 2023. Convenience sampling and snowballing were used for recruitment.

104 patients were interviewed (52 HZ/52 PHN; each: Hong Kong [n = 4]/Mainland China [n = 36]/South Korea [n = 6]/Taiwan [n = 6]). All patients described physical and emotional effects of HZ. The most common symptoms were pain (100%) and rash (86%). The main reason for seeking diagnosis was rash (72%). Pain was the most bothersome symptom (89%); 83% of patients reported their worst pain level as ≥8 (scale 0-10 [most painful]). The most affected HRQoL domains were sleep (100%), emotional functioning (90%), and activities of daily living (89%). Concept saturation was reached. Unmet needs throughout the patient journey included low patient awareness of HZ, poor physician-patient communication on vaccination (eg, benefits and risks), and lack of community support. Patients with comorbidities, including end-stage renal disease, reported additional burden due to HZ. Sixty-nine percent of patients reported HZ vaccination willingness.

Understanding the patient experience helps to meet healthcare needs (eg, informing healthcare decision making to prevent HZ). The East Asian HZ conceptual model was consistent with the Canadian model, validating it to the East Asia context.