Transplantation direct · 2026
Do we Treat the Right Patients? Predictors of Psychosocial Treatment Frequencies in a Multimodal Aftercare Program: A KTx360° Substudy.
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Kuczyk Charlotte, de Zwaan Martina, Klewitz Felix, Bauer-Hohmann Maximilian, Debener Aline, Erim Yesim, Schiffer Lena, Haufe Sven, Tegtbur Uwe, Pape Lars, Schiffer Mario, Nöhre Mariel
Аннотация
BACKGROUND: Psychosocial interventions are essential in multimodal aftercare for kidney transplant recipients. However, it remains unclear whether they effectively reach patients with low adherence or elevated mental distress.
METHODS: We investigated (1) the frequency of suboptimal adherence and mental distress at any point during the aftercare program Kidney Transplantation 360° study (KTx360°), a multicenter, multisectoral, multimodal, telemedicine-based follow-up care model; (2) the rate of psychosocial intervention utilization, and (3) the association between these factors, along with demographic and clinical characteristics, and intervention uptake. This analysis draws on a sample of n = 838 participants. Participants with and without utilization of psychosocial interventions were compared using chi-square tests and Mann-Whitney U tests as appropriate. Logistic regression estimated predictors of utilization.
RESULTS: Suboptimal adherence and mental distress were frequently observed in our cohort, affecting 60.6% (n = 508) of participants at some point during the study. Utilization remained limited, with only 27.6% (n = 140) of affected individuals engaging with them. Still, higher levels of suboptimal adherence (ß = 0.48; P = 0.012) and mental distress (depression [ß = 0.74; P < 0.001], anxiety [ß = 0.69; P = 0.001]) were linked to greater intervention use-alongside female sex (ß = -0.43; P = 0.018) and retransplantation status (ß = 0.51; P = 0.034).
CONCLUSIONS: Even though suboptimal adherence and increased mental distress were associated with a higher utilization of psychosocial intervention, the majority of affected patients were not reached, highlighting a significant gap between need and access. Understanding patterns of utilization is crucial when designing scalable and feasible psychosocial interventions for transplant recipients.
METHODS: We investigated (1) the frequency of suboptimal adherence and mental distress at any point during the aftercare program Kidney Transplantation 360° study (KTx360°), a multicenter, multisectoral, multimodal, telemedicine-based follow-up care model; (2) the rate of psychosocial intervention utilization, and (3) the association between these factors, along with demographic and clinical characteristics, and intervention uptake. This analysis draws on a sample of n = 838 participants. Participants with and without utilization of psychosocial interventions were compared using chi-square tests and Mann-Whitney U tests as appropriate. Logistic regression estimated predictors of utilization.
RESULTS: Suboptimal adherence and mental distress were frequently observed in our cohort, affecting 60.6% (n = 508) of participants at some point during the study. Utilization remained limited, with only 27.6% (n = 140) of affected individuals engaging with them. Still, higher levels of suboptimal adherence (ß = 0.48; P = 0.012) and mental distress (depression [ß = 0.74; P < 0.001], anxiety [ß = 0.69; P = 0.001]) were linked to greater intervention use-alongside female sex (ß = -0.43; P = 0.018) and retransplantation status (ß = 0.51; P = 0.034).
CONCLUSIONS: Even though suboptimal adherence and increased mental distress were associated with a higher utilization of psychosocial intervention, the majority of affected patients were not reached, highlighting a significant gap between need and access. Understanding patterns of utilization is crucial when designing scalable and feasible psychosocial interventions for transplant recipients.