Incidence and Management of Postherpetic Neuralgia in Primary Care: A Multicentre Retrospective Study.

IF 1.2 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Acta medica portuguesa Pub Date : 2026-10-01 DOI:10.20344/amp.24735

Alcino Duarte, Inês Gonçalo, Inês Lopes, Isabel Carneiro Santos, João Carlos Silveira, Pedro Ferreira de Lemos, Daniel Humberto Pozza, Célia Duarte Cruz

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引用次数: 0

Abstract

Introduction: This study aimed to characterize postherpetic neuralgia (PHN) in herpes zoster (HZ) patients in primary care and assess its treatment. The secondary objectives included evaluating pain records and analgesic prescriptions.

Methods: A multicentric observational, descriptive, longitudinal, and retrospective study was conducted in five Family Health Units, including adult patients diagnosed with HZ between January 2013, and December 2023, using the S70 code (International Classification of Primary Care - ICPC-2). Duplicate cases, pregnant women, and deceased individuals at time of data collection were excluded.

Results: We included 735 individuals with HZ, 65% of whom were female and 81.2% were aged 50 years or older. The thoracoabdominal region was the most frequently affected, accounting for 43.7% of cases. In the initial assessment antivirals were prescribed to 81.1% and analgesics to 60.7%, predominantly nonsteroidal anti-inflammatory drugs. The cumulative incidence of PHN was 8.6% and every patient was receiving pain medication. No significant association was found between antiviral therapy and PHN (p = 0.165) or between depression/anxiety and PHN (p = 0.154). Additionally, in a complete‑case analysis, the absence of an analgesic prescription in the first consultation was associated with higher odds of PHN, although this association was not statistically significant (OR = 1.60; 95% CI 0.25 - 10.05, p = 0.546). The incidence of postherpetic neuralgia appeared slightly lower than prior reports.

Conclusion: Antiviral use showed no association with subsequent PHN, whereas the absence of an analgesic prescription in the first consultation was associated with a higher risk of diagnosis, reinforcing the need for timely pain control. Depression and anxiety were common but not linked to PHN. Despite retrospective limitations, these findings emphasize that systematic pain assessment and early analgesic intervention in primary care can lessen the PHN burden.

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初级保健中带状疱疹后神经痛的发生率和处理：一项多中心回顾性研究。

简介：本研究旨在探讨带状疱疹（HZ）患者初级保健中的带状疱疹后带状神经痛（PHN）特征，并评估其治疗方法。次要目的包括评估疼痛记录和镇痛处方。方法：采用S70编码（国际初级保健分类- ICPC-2），在五个家庭卫生单位进行了一项多中心观察性、描述性、纵向和回顾性研究，包括2013年1月至2023年12月诊断为HZ的成年患者。在数据收集时排除重复病例、孕妇和死亡个体。结果：我们纳入了735例HZ患者，其中65%为女性，81.2%年龄在50岁或以上。胸腹区最常见，占43.7%。在初步评估中，使用抗病毒药物的占81.1%，使用镇痛药的占60.7%，主要是非甾体类抗炎药。PHN的累计发生率为8.6%，每例患者均在接受止痛药治疗。抗病毒治疗与PHN无显著相关性（p = 0.165），抑郁/焦虑与PHN无显著相关性（p = 0.154）。此外，在一个完整的病例分析中，第一次就诊时没有止痛药处方与PHN的高几率相关，尽管这种关联没有统计学意义（OR = 1.60;95% CI 0.25 - 10.05,p = 0.546）。疱疹后神经痛的发生率比以前的报道略低。结论：抗病毒药物的使用与随后的PHN无关，而第一次就诊时没有止痛药处方与更高的诊断风险相关，从而加强了及时控制疼痛的必要性。抑郁和焦虑很常见，但与PHN无关。尽管存在回顾性局限性，但这些研究结果强调，在初级保健中进行系统的疼痛评估和早期镇痛干预可以减轻PHN负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta medica portuguesa MEDICINE, GENERAL & INTERNAL-

CiteScore

1.90

自引率

16.70%

发文量

256

审稿时长

6-12 weeks

期刊介绍： The aim of Acta Médica Portuguesa is to publish original research and review articles in biomedical areas of the highest standard, covering several domains of medical knowledge, with the purpose to help doctors improve medical care. In order to accomplish these aims, Acta Médica Portuguesa publishes original articles, review articles, case reports and editorials, among others, with a focus on clinical, scientific, social, political and economic factors affecting health. Acta Médica Portuguesa will be happy to consider manuscripts for publication from authors anywhere in the world.