Current Heart Failure Reports

, Volume 15, Issue 2, pp 70–74 | Cite as

The Psychosocial Treadmill: the Road to Improving High-risk Behavior in Advanced Therapy Candidates

  • Laura NewmanEmail author
Nonpharmacologic Therapy: Surgery, Ventricular Assist Devices, Biventricular Pacing, and Exercise (A. Hasan, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Nonpharmacologic Therapy: Surgery, Ventricular Assist Devices, Biventricular Pacing, and Exercise


Purpose of Review

The purpose of this review is to explore the evaluation and identification of psychosocial risk factors during the heart transplant evaluation process with the goal of improving psychosocial candidacy prior to transplant listing. Subsequently, more patients will be able to receive life-saving heart transplant and experience success after transplant.

Recent Findings

Evaluating and identifying psychosocial risk factors is an essential component of the transplant evaluation process. Less research exists demonstrating how patients may be able to reduce psychosocial risk factors over time to improve their candidacy for transplant. This review will describe a program developed for patients undergoing heart transplant evaluation at The Ohio State University Wexner Medical Center to improve their psychosocial risk.


By implementing a comprehensive, multidisciplinary intervention to address psychosocial risk factors pre-transplant, patients can improve their psychosocial candidacy and go on to be listed for heart transplant.


Heart transplant Psychosocial evaluation Adherence Psychosocial candidacy Health coaching 


Compliance with Ethical Standards

Conflict of Interest

Laura Newman declares no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. 1.
    •• Coglianese EE, Samsi M, Liebo MJ, Heroux AL. The value of psychosocial factors in patient selection and outcomes after heart transplantation. Curr Heart Fail Rep. 2015;12:42–7. Excellent article detailing the importance of psychosocial factors and how they impact outcomes.CrossRefPubMedGoogle Scholar
  2. 2.
    Kuntz K, Weinland SR, Butt Z. Psychosocial challenges in solid organ transplantation. J Clin Psychol Med Settings. 2015;22(2-3):122–35. Scholar
  3. 3.
    Dew M, Rosenberger E, Myaskovsky L, DiMartini A, DeVito Dabbs A, Posluszny D, et al. Depression and anxiety as risk factors for morbidity and mortality after organ transplantation: a systematic review and meta-analysis. Transplantation. 2015;100(5):988–1003. Scholar
  4. 4.
    Sanchez R, Bailles E, Peri JM, Bastidas A, Perez-Villa F, Bulbena A, et al. Assessment of psychosocial factors and predictors of psychopathology in a sample of heart transplantation recipients: a prospective 12 months follow up. Gen Hosp Psychiatry. 2016;38:59–64. Scholar
  5. 5.
    Kuming M, Jowsey-Gregoire S. Preoperative psychological evaluation of transplant patients: challenges and solutions. Transplant Res Risk Manag. 2015;7:35–43.CrossRefGoogle Scholar
  6. 6.
    •• Rosenberger E, Fox K, DiMartini A, Dew M. Psychosocial factors and quality-of-life after heart transplantation and mechanical circulatory support. Curr Opin Organ Transplant. 2012;17(5):558–63. A good article highlighting the concerns with transplant and mechanical circulatory support patients.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Maldonado JR, Dubois HC, David EE, Sher Y, Lolak S, Dyal J, et al. The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT): a new tool for the psychosocial evaluation of pre-transplant candidates. Psychosomatics. 2012;53(2):123–32. Scholar
  8. 8.
    Maltby MC, Flattery MP, Burns B, Salyer J, Weinland S, Shah KB. Psychosocial assessment of candidates and risk classification of patients considered for durable mechanical circulatory support. J Heart Lung Transplant. 2014;33(8):836–41. Scholar
  9. 9.
    •• Maldonado J, Sher Y, Lolak S, Swendson H, Skibola D, Neri E, et al. The Stanford integrated psychosocial assessment for transplantation: a prospective study of medical and psychosocial outcomes. Psychosom Med. 2015;77(9):1018–30. A good update to the original article regarding the SIPAT as an evaluation tool and how it relates to outcomes.CrossRefPubMedGoogle Scholar
  10. 10.
    DiMartini A, Crone C, Fireman M, Dew M. Psychiatric aspects of organ transplantation in critical care. Crit Care Clin. 2008;24(4):949-x.CrossRefPubMedCentralGoogle Scholar
  11. 11.
    Bruce CR, Delgado E, Kostick K, Grogan S, Ashrith G, Trachtenberg B, et al. Ventricular assist devices: a review of psychosocial risk factors and their impact on outcomes. J Card Fail. 2014;20(12):996–1003. Scholar
  12. 12.
    •• Easthall C, Barnett N. Using theory to explore the determinants of medication adherence; moving away from a one-size-fits-all approach. Pharmacy (Basel). 2017;5(3):50. Excellent article linking motivational interviewing and health coaching to improving adherence, and focusing on a patient-centered approach.CrossRefGoogle Scholar
  13. 13.
    Nafradi K, Nakamoto K, Schulz PJ. Is patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of control, and medication adherence. PLoS One. 2017;12(10):e0186458. Scholar
  14. 14.
    Brocks Y, Zittermann A, Grisse D, Schmid-Ott G, Stock-GieBendanner S, Schulz U, et al. Adherence of heart transplant recipients to prescribed medication and recommended lifestyle habits: a single-center experience. Prog Transplant. 2017;27(2):160–6. Scholar
  15. 15.
    Ehrlich KB, Miller GE, Scheide T, Baveja S, Weiland R, Galvin J, et al. Pre-transplant emotional support is associated with longer survival after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant. 2016;51(12):1594–8. Scholar
  16. 16.
    Hartmann M, Bazner E, Wild B, Eisler I, Herzog W. Effects of interventions involving the family in the treatment of adult patients with chronic physical diseases: a meta-analysis. Psychother Psychosom. 2010;79(3):136–48. Scholar
  17. 17.
    Lee KS, Moser DK, Dracup K. Relationship between self-care and comprehensive understanding of heart failure and its signs and symptoms. Eur J Cardiovasc Nurs 2017;1474515117745056.

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.The Ohio State University Wexner Medical CenterColumbusUSA

Personalised recommendations