Transplant patients need mental health resources, education, support due to pandemic

Patients on dialysis and patients receiving care for transplantation reported a need for increased mental health resources, patient-focused education and support following the COVID-19 pandemic, according to published data.

Further, patients reported more frequent and severe panic attacks as a direct result of the pandemic.

“While the world has been combating the challenges of COVID-19, immunocompromised patients, such as patients with [chronic kidney disease] CKD and solid organ transplants, are even more vulnerable,” Yaquelin A. Arevalo Iraheta, BS, from the David Geffen School of Medicine at the University of California, and colleagues wrote. They added, “To truly understand patients’ lived experience during a global pandemic, we created the COVID-19 Kidney and Transplant Listening and Resource Center (KTLRC), a telephone hotline to learn, in real time, about the specific challenges and stressors that dialysis and transplant patients were facing and to disseminate transplant-related education about COVID-19, including mental health resources.”

In a mixed-methods study, researchers examined the COVID-19 pandemic experiences and information-seeking behaviors of 99 patients (25.3% were Hispanic; 23.2% were white; 24.2% were Asian; 24.2% were Black). All participants were recruited through social media and transplant center’s electronic medical records, totaling to 28 patients on dialysis and 71 transplant patients.

Researchers conducted semi-structured, qualitative interviews and surveys between June 17, 2020, and November 24, 2020. Interviews included open-ended questions about patients’ COVID-19 pandemic experience, health care delivery during that time and suggestions for improvement within the health care community.

Patients completed a quantitative survey to provide demographic characteristics, participant type, primary language spoken and education level. Additionally, researchers screened patients for anxiety and depression, and they asked patients how they were learning about COVID-19.

Researchers used thematic analyses to determine qualitative themes from interviews.

Overall, researchers identified seven themes that included many stressors due to COVID-19 such as postponing medical visits, limited accessibility to medication, difficulty in receiving up-to-date and patient-focused health information, difficulty in receiving dialysis supplies, delays in medical appointments, losses of health insurance and income, and increased vigilance to avoid contracting the virus. Among the group, 15 patients showed moderate to severe anxiety and depression symptoms and reported more frequent panic attacks following the pandemic.

Patients reported needing more transplant-specific updates regarding COVID-19 in addition to more frequent communication from their kidney and transplant specialists.

“The pandemic created both high levels of mental health strain for dialysis and transplant patients and difficulty coordinating care by the health-care community. It provided insights into the psychological and practical challenges immunosuppressed patients face and the actions they take to protect the safety of their health, with or without a pandemic,” Arevalo Iraheta and colleagues wrote. “The gaps in support services identified need to be explored so that health information is made readily available faster and addresses patients’ emotional needs.”