Utility of the psychosocial assessment of candidates for transplantation (PACT) scale in allogeneic BMT

Abstract

. The PACT has eight subscales, each rated on a 5-point scale, and an initial and final rating independently based on the rater's overall impressions of the candidate's acceptability for transplant. This exploratory study assessed the clinical utility of the PACT scale for psychosocial screening in allogeneic BMT. Associations of the PACT subscales and the final rating with sixteen post transplant medical outcomes were examined using the Jonchkheere-Terpstra test, the Cochran-Armitage test or the Cox proportional hazards analysis. Significant relationships (Pp0.05) between PACT subscales and medical outcomes are as follows: better compliance with medications and medical advice associates with lower in-hospital mortality, shorter length of stay and readmission duration, and faster neutrophil and platelet engraftment; better scores on drug/alcohol use associates with faster platelet engraftment; better scores on family/support system availability and on relevant knowledge and receptiveness to education associates with decreased risk of mortality. The final rating score and medical outcomes are not significantly related; however, study findings underscore the prognostic value of the PACT subscales and the potential utility for screening of BMT candidates.

Data mining of mental health issues of non-bone marrow donor siblings

“…Previous paper showed that better scores on family support were associated with decreased risk of mortality or reduced patients' anxiety, suggesting that psycho-social care for patient family should be considered for better treatment outcome [29,35,36]. Therefore the approach in this case presentation suggests clinical availability in psycho-social care.…”

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

“…The decision-making process for selecting appropriate candidates for allogeneic HCT is complex and considers several patient, disease and transplant-related factors, including an assessment of social and psychological risk factors. We demonstrate that the PACT instrument can provide objective parameters to facilitate psychosocial risk assessment and builds on previous work in a smaller cohort of patients published from our center [27]. Using the PACT scale, we highlight risk factors that may identify a subgroup of vulnerable patients from a psychosocial perspective who may need additional vigilance, support and resources to successfully help them navigate the transplantation procedure.…”

“…While a possible association between survival and PACT score has been reported in solid organ transplant recipients [21], there are conflicting data on the influence of psychosocial comorbidities on HCT outcomes [22][23][24][25][26]. In a previous prospective study, we evaluated the utility of the PACT assessment and association of outcomes in HCT recipients [27]. However, this was a relatively small study with short follow-up and it did not consider sociodemographic and patient-reported factors.…”

Psychosocial Evaluation in Patients Undergoing Left Ventricular Assist Device Implantation Using the Transplant Evaluation Rating Scale

“…[9,10] The Psychological Assessment of Candidates for Transplantation (PACT) and the Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) have been used for pre-transplant psychological evaluation. [11,12] The PACT, previously used in psychosocial evaluation of transplant patients, and the modified version of PACT (mPACT) have been used for assessment in one small retrospective study of 48 LVAD patients. [13] Patients classified as low risk with higher mPACT scores had decreased 30 day readmission rates in this study.…”