Psychosocial Diagnosis and Treatment Before and After Organ Transplantation. 2023

Martina de Zwaan, and Yesim Erim, and Sylvia Kröncke, and Frank Vitinius, and Angela Buchholz, and Mariel Nöhre, and
Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover; Department of Medical Psychology at the Universitätsklinikum Hamburg-Eppendorf, Hamburg; Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg; Department of Psychosomatics and Psychotherapy, University Hospital Cologne.

This new clinical practice guideline concerns the psychosocial diagnosis and treatment of patients before and after organ transplantation. Its objective is to establish standards and to issue evidence-based recommendations that will help to optimize decision making in psychosocial diagnosis and treatment. For each key question, the literature was systematically searched in at least two databases (Medline, Ovid, Cochrane Library, and CENTRAL). The end date of each search was between August 2018 and November 2019, depending on the question. The literature search was also updated to capture recent publications, by using a selective approach. Lack of adherence to immunosuppressant drugs can be expected in 25-30% of patients and increases the odds of organ loss after kidney transplantation (odds ratio 7.1). Psychosocial interventions can significantly improve adherence. Metaanalyses have shown that adherence was achieved 10-20% more frequently in the intervention group than in the control group. 13-40% of patients suffer from depression after transplantation; mortality in this group is 65% higher. The guideline group therefore recommends that experts in psychosomatic medicine, psychiatry, and psychology (mental health professionals) should be involved in patient care throughout the transplantation process. The care of patients before and after organ transplantation should be multidisciplinary. Nonadherence rates and comorbid mental disorders are common and associated with poorer outcomes after transplantation. Interventions to improve adherence are effective, although the pertinent studies display marked heterogeneity and a high risk of bias.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000078202 Systematic Reviews as Topic Works about a review of primary literature in health and health policy that attempt to identify, appraise, and synthesize all the empirical evidence that meets specified eligibility criteria to answer a given research question. It's conducted using explicit methods aimed at minimizing bias in order to produce more reliable findings regarding the effects of interventions for prevention, treatment, and rehabilitation that can be used to inform decision making. Systematic Review as Topic,Umbrella Reviews as Topic,Reviews Systematic as Topic
D001007 Anxiety Feelings or emotions of dread, apprehension, and impending disaster but not disabling as with ANXIETY DISORDERS. Angst,Anxiousness,Hypervigilance,Nervousness,Social Anxiety,Anxieties, Social,Anxiety, Social,Social Anxieties
D016377 Organ Transplantation Transference of an organ between individuals of the same species or between individuals of different species. Grafting, Organ,Transplantation, Organ,Graftings, Organ,Organ Grafting,Organ Graftings,Organ Transplantations,Transplantations, Organ
D017410 Practice Guidelines as Topic Works about directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. Clinical Guidelines as Topic,Best Practices,Best Practice

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