Implementing an Integrated Psychology Preventative Care Model in Pediatric Solid Organ Transplant

Abstract

Objective:

The initial posttransplant period is high-risk in terms of susceptibility to rejection episodes and poor medical outcomes for pediatric solid organ transplant (SOT) patients. Psychologists play an important role on transplant medical teams to support patients and families in improving adherence and graft outcomes. This article describes a new psychology-integrated preventative care model implemented in 2019 and examines trends in service delivery pre- and postimplementation.

Method:

Universal health and behavior assessment and intervention were delivered to SOT (heart, liver, and kidney) patients according to a structured method of service delivery that identified distinct time points for follow-up within the first 3-year posttransplantation.

Results:

Preimplementation, the SOT psychology service delivered intervention and assessment services to 44% of patients who were transplanted during the preimplementation period; postimplementation, 97% of this patient population were seen by SOT psychology. Mean psychology contacts increased significantly postimplementation (M = 2.55) of this new preventative care model, compared to preimplementation (M = 1.59).

Conclusions:

Psychology support is an essential component of comprehensive pediatric SOT care. Increased psychology services posttransplantation can effectively identify and target psychosocial needs for patients and families.

Implications for Impact Statement

This article describes a new integrated preventative care model of psychology service delivery within pediatric solid organ transplant that greatly increased assessments and interventions during the vulnerable first 3-year posttransplant. This preventative care model allows pediatric psychologists to address adherence, behavioral and emotional concerns, and coping with illness to support optimal posttransplant psychological and medical outcomes.