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

Abstract

The psychosocial assessment of candidates for transplantation (PACT) scale was completed before the transplant on 120 patients who underwent allogeneic transplant from November 2003 to June 2007. 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 (P<or=0.05) 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.