{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:23:15Z","timestamp":1784697795756,"version":"3.55.0"},"reference-count":24,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background\/Objectives: Herpes zoster (shingles), caused by reactivation of the varicella zoster virus, often leads to acute pain that may progress to postherpetic neuralgia (PHN). Current evidence is insufficient to determine the optimal interventional treatment for these conditions. This study aimed to evaluate the effectiveness of shared decision-making (SDM) forms developed by MacKay Memorial Hospital (MMH) in reducing patient anxiety and improving personalized care. Method: Between 1 August 2022 and 30 August 2024, we retrospectively reviewed SDM records of patients with shingles pain and PHN who were referred to the pain clinic for interventional treatment due to unresolved pain. The SDM forms were developed, reviewed, and authorized by the MMH Committee of Medical Quality and Safety. We analyzed the chosen interventions, anxiety levels, pain intensity, and patient preferences regarding treatment selection. Results: A total of 51 individuals (36 with shingles pain, 15 with PHN) were included in this cohort study. Most patients with acute or chronic zoster pain opted for subcutaneous steroid injections. Anxiety scores significantly decreased following SDM intervention, from 5.0 (IQR: 3.5\u20135.0) to 3.0 (IQR: 2.0\u20133.0) in shingles patients and from 5.0 (IQR: 4.0\u20135.0) to 2.0 (IQR: 2.0\u20133.0) in PHN patients. Pain intensity, measured using the numerical rating scale (NRS), also improved markedly after interventional pain management, with scores reducing from 8.0 (IQR: 6.0\u20139.0) to 3.0 (IQR: 1.0\u20136.5) in shingles patients and from 5.0 (IQR: 4.0\u20138.0) to 2.0 (IQR: 1.0\u20133.0) in PHN patients. Shingles patients expressed greater concern about the risks of interventional therapy complications, whereas PHN patients prioritized cost, complication rates, treatment frequency, and continuity of care. Additionally, SDM forms received high scores for promoting patient participation and knowledge, indicating that they improved their understanding of their condition and treatment options. Conclusions: SDM significantly improved patient comprehension, reduced anxiety, facilitated informed treatment decisions, and strengthened doctor\u2013patient communication for those with shingles pain and PHN.<\/jats:p>","DOI":"10.3390\/jpm15050191","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T06:47:15Z","timestamp":1746686835000},"page":"191","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["From Consultation to Collaboration: A Patient-Centered Approach to Shingles Pain and Postherpetic Neuralgia Management"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9370-2023","authenticated-orcid":false,"given":"Yin-Tse","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Medicine, MacKay Medical University, New Taipei City 252005, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0143-3556","authenticated-orcid":false,"given":"Hsuan-Chih","family":"Lao","sequence":"additional","affiliation":[{"name":"Department of Medicine, MacKay Medical University, New Taipei City 252005, Taiwan"},{"name":"Department of Anesthesiology, MacKay Memorial Hospital, Taipei 104217, Taiwan"},{"name":"Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1035-7815","authenticated-orcid":false,"given":"Sheng-Chin","family":"Kao","sequence":"additional","affiliation":[{"name":"Department of Medicine, MacKay Medical University, New Taipei City 252005, Taiwan"},{"name":"Department of Anesthesiology, MacKay Memorial Hospital, Taipei 104217, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8629-5449","authenticated-orcid":false,"given":"Ying-Chun","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medicine, MacKay Medical University, New Taipei City 252005, Taiwan"},{"name":"Department of Anesthesiology, MacKay Memorial Hospital, Taipei 104217, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7505-0032","authenticated-orcid":false,"given":"Ying-Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Medicine, MacKay Medical University, New Taipei City 252005, Taiwan"},{"name":"Department of Anesthesiology, MacKay Memorial Hospital, Taipei 104217, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Hsin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, MacKay Memorial Hospital, Taipei 104217, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Jun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, MacKay Memorial Hospital, Taipei 104217, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"ref_1","first-page":"656","article-title":"Herpes Zoster and Postherpetic Neuralgia: Prevention and Management","volume":"96","author":"Saguil","year":"2017","journal-title":"Am. Fam. Physician"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/j.jmii.2024.06.001","article-title":"Recommendations and guidance for herpes zoster vaccination for adults in Taiwan","volume":"57","author":"Lin","year":"2024","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1016\/j.vaccine.2009.11.029","article-title":"Disease burden and epidemiology of herpes zoster in pre-vaccine Taiwan","volume":"28","author":"Lin","year":"2010","journal-title":"Vaccine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1016\/j.idc.2017.07.016","article-title":"Herpes Zoster in the Older Adult","volume":"31","author":"John","year":"2017","journal-title":"Infect. Dis. Clin. North Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1056\/NEJMcp1403062","article-title":"Clinical practice. Postherpetic neuralgia","volume":"371","author":"Johnson","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"21","DOI":"10.3344\/kjp.2013.26.1.21","article-title":"Survey on the treatment of postherpetic neuralgia in Korea; multicenter study of 1414 patients","volume":"26","author":"Nahm","year":"2013","journal-title":"Korean J. Pain"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"209","DOI":"10.36076\/ppj\/2019.22.209","article-title":"Interventional Treatments for Postherpetic Neuralgia: A Systematic Review","volume":"22","author":"Lin","year":"2019","journal-title":"Pain Physician"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1002\/hast.671","article-title":"The Theory and Practice of Surrogate Decision-Making","volume":"47","author":"Wendler","year":"2017","journal-title":"Hastings Cent. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1111\/acem.13065","article-title":"What Is Shared Decision Making? (and What It Is Not)","volume":"23","author":"Kunneman","year":"2016","journal-title":"Acad. Emerg. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"ofae211","DOI":"10.1093\/ofid\/ofae211","article-title":"Incidence of Herpes Zoster and Postherpetic Neuralgia and Herpes Zoster Vaccination Uptake in a US Administrative Claims Database","volume":"11","author":"Marcum","year":"2024","journal-title":"Open Forum Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1093\/cid\/ciw296","article-title":"Increasing Incidence of Herpes Zoster Over a 60-year Period From a Population-based Study","volume":"63","author":"Kawai","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1056\/NEJMcp1302674","article-title":"Herpes Zoster","volume":"369","author":"Cohen","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2344983","DOI":"10.1080\/21645515.2024.2344983","article-title":"A systematic literature review of the epidemiology and burden of herpes zoster in selected locales in Asia Pacific","volume":"20","author":"Chen","year":"2024","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Chiu, H.H., Chang, S.L., Cheng, H.M., Chao, T.F., Lin, Y.J., Lo, L.W., Hu, Y.F., Chung, F.P., Liao, J.N., and Tuan, T.C. (2023). Shared decision making for anticoagulation reduces anxiety and improves adherence in patients with atrial fibrillation. BMC Med. Inform. Decis. Mak., 23.","DOI":"10.1186\/s12911-023-02260-x"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"17","DOI":"10.20849\/ijsn.v5i3.765","article-title":"Clinical efficiency analysis of share decision making in the atrial fibrillation patients","volume":"5","author":"Cheng","year":"2020","journal-title":"Int. J. Stud. Nurs."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.jhsg.2022.05.003","article-title":"Shared Decision-Making Tool for Opioid Prescribing After Ambulatory Orthopedic Surgery in Veterans: A Randomized Controlled Clinical Trial","volume":"4","author":"Bolson","year":"2022","journal-title":"J. Hand Surg. Glob. Online"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"An, K., Wu, Z., Qiu, Y., Pan, M., Zhang, L., An, Z., and Li, S. (2023). Shared decision making in sarcopenia treatment. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1296112"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1188\/19.CJON.540-542","article-title":"Shared Decision Making: Improving Patient Outcomes by Understanding the Benefits of and Barriers to Effective Communication","volume":"23","author":"Faiman","year":"2019","journal-title":"Clin. J. Oncol. Nurs."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1097\/01.PSY.0000097336.95046.0C","article-title":"Effect on disability outcomes of a depression relapse prevention program","volume":"65","author":"Katon","year":"2003","journal-title":"Psychosom. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1017\/S003329170300816X","article-title":"Behavioural factors associated with symptom outcomes in a primary care-based depression prevention intervention trial","volume":"33","author":"Ludman","year":"2003","journal-title":"Psychol. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3293","DOI":"10.1200\/JCO.2004.05.066","article-title":"Randomized trial of a shared decision-making intervention consisting of trade-offs and individualized treatment information for BRCA1\/2 mutation carriers","volume":"22","author":"Stalmeier","year":"2004","journal-title":"J. Clin. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"117132","DOI":"10.1016\/j.socscimed.2024.117132","article-title":"The causal impact of shared decision making on pain outcomes: Gender matters","volume":"355","author":"Brown","year":"2024","journal-title":"Soc. Sci. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1016\/j.socscimed.2009.09.056","article-title":"Exploring patient involvement in healthcare decision making across different education and functional health literacy groups","volume":"69","author":"Smith","year":"2009","journal-title":"Soc. Sci. Med."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Kikuchi, R., Kingston, P., Hao, A., Sadrolashrafi, K., Yamamoto, R.K., Tolson, H., Bilimoria, S.N., Guo, L., Yee, D., and Ochoa, M.T. (2024). Shared decision-making in psoriasis care: Evaluation of how patients\u2019 perception of clinicians\u2019 delivery of care changes by age and sex. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0303058"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/15\/5\/191\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:29:20Z","timestamp":1760030960000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/15\/5\/191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,8]]},"references-count":24,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["jpm15050191"],"URL":"https:\/\/doi.org\/10.3390\/jpm15050191","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,8]]}}}