Psychosocial Challenges in Solid Organ Transplantation

Kuntz, Kristin; Weinland, Stephan R.; Butt, Zeeshan

doi:10.1007/s10880-015-9435-6

Cited by 40 publications

(35 citation statements)

References 98 publications

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“…For example, there are multiple psychosocial factors that have been described as having an impact on the success of solid organ transplant (Kuntz et al, 2015). For example, there are multiple psychosocial factors that have been described as having an impact on the success of solid organ transplant (Kuntz et al, 2015).…”

Section: Other Factors To Considermentioning

confidence: 99%

In pursuit of empirically supported assessment for use in medical settings.

Butt¹

2016

Clinical Psychology: Science and Practice

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Psychological assessment in the medical setting presents many opportunities and challenges. On the question of what constitutes empirically supported assessment practice, there are few clear answers and perhaps fewer exemplars. The goal of this article was not to review the current status of empirically supported assessment in medical settings, but rather to highlight some areas of measurement innovation that may move this field toward its promise of a more stable evidence base supporting the use of patient-reported outcome measures for clinical research, patient education, and clinical care. In addition, assessment in the medical setting provides one very unique opportunity that many psychologists are not honed in on: the use of psychological assessment to assess quality health care. This is an emerging reality that poses significant methodological puzzles and opens doors for those committed to psychological assessment.

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Section: Other Factors To Considermentioning

confidence: 99%

In pursuit of empirically supported assessment for use in medical settings.

Butt¹

2016

Clinical Psychology: Science and Practice

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“…21 A history of substance abuse or other risky health behaviors, low medication compliance, poor social support, psychosis, or cognitive dysfunction before transplant are strong indicators that these problems will return posttransplant and may affect medical compliance and outcomes. [22][23][24] Psychiatric care interventions including psychotherapy or medication management are effective in treating these conditions and may mitigate negative effects on transplant outcomes. These issues however must first be identified by the transplant team and patients must receive mental health (MH) or chemical dependency (CD) services without delay.…”

Section: Introductionmentioning

confidence: 99%

“…Posttransplant depression is associated with graft rejection, malignancy, and mortality, as are smoking and substance use disorders . A history of substance abuse or other risky health behaviors, low medication compliance, poor social support, psychosis, or cognitive dysfunction before transplant are strong indicators that these problems will return posttransplant and may affect medical compliance and outcomes …”

Section: Introductionmentioning

confidence: 99%

Mental health and chemical dependency services at US transplant centers

Niazi

Spaulding

Vargas

et al. 2020

American Journal of Transplantation

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The purpose of this study was to assess the availability of mental health (MH) and chemical dependency (CD) services at US transplant centers, because appropriate psychosocial assessment and care is associated with better transplant outcomes. We used the 2017‐2018 American Hospital Association survey, Area Health Resource File, and Centers for Medicare & Medicaid Services Hospital Compare databases to quantify availability of services and examined associations of hospital‐ and health services area‐level characteristics with odds of offering services with generalized linear mixed models. We found that 15% of transplant centers did not offer MH services and 62% did not offer CD services. Hospitals were more likely to offer MH services if they were larger (OR [95% CI]: 1.03 [1.01, 1.06]) and had a lower rate of uninsured patients in the health services area (OR [95% CI]: 0.89 [0.80, 0.99]) and were more likely to offer CD services if they were larger (OR [95% CI]: 1.02 [1.01, 1.03]) or were members of a system (OR [95% CI]: 2.31 [1.26, 4.24]). Additional research is needed to understand whether lack of MH or CD services at transplant centers affects patients’ ability to access comprehensive psychosocial care and whether this affects patient outcomes.

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“…Historically, psychosocial evaluations for solid organ transplantations have been conducted as a standard of practice for candidacy selection and patient care because there is a limited supply of donor organs [17][18][19]. While there is a lack of a standard instrument, the Psychosocial Assessment of Candidates for Transplantation (PACT) scale is a tool that is validated and routinely used to stratify psychosocial risk among solid organ transplant recipients [19,20].…”

Section: Introductionmentioning

confidence: 99%

Psychosocial Assessment of Candidates for Transplant (PACT) as a tool for psychological and social evaluation of allogeneic hematopoietic cell transplantation recipients

Hong

Rybicki

Corrigan

et al. 2019

Bone Marrow Transplant

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Psychosocial Assessment of Candidates for Transplant (PACT) is a tool originally developed to address psychosocial risks in solid organ transplant recipients and has the potential for application to hematopoietic cell transplantation (HCT) recipients. In a retrospective cohort study, we reviewed 404 adult allogeneic HCT cases from 2003 to 2014 to identify predictors of adverse psychosocial status as determined by PACT. Final PACT rating was poor/borderline (score 0-1) in 5%, acceptable (score 2) in 22%, good (score 3) in 44%, and excellent (score 4) in 29% recipients. In multivariable regression, higher PACT score was associated with White race (odds ratio [OR] 2.95, P < 0.001), having a related donor (OR 1.61, P = 0.015), and a higher quality of life score (OR 1.22/ 10-point increase in FACT-BMT total score, P < 0.001). PACT score correlated with all quality of life subscales. The final PACT score was associated with non-relapse mortality (HR 0.82/ 1-point increase, p = 0.03) in multivariable analysis that considered patient and disease factors, but not in models that also included transplant-related factors and performance status. PACT score was not associated with overall survival. PACT can be considered as part of a comprehensive psychosocial assessment for identifying patients who may require additional resources around allogeneic HCT.

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Psychosocial Challenges in Solid Organ Transplantation

Cited by 40 publications

References 98 publications

In pursuit of empirically supported assessment for use in medical settings.

In pursuit of empirically supported assessment for use in medical settings.

Mental health and chemical dependency services at US transplant centers

Psychosocial Assessment of Candidates for Transplant (PACT) as a tool for psychological and social evaluation of allogeneic hematopoietic cell transplantation recipients

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