Quality of life and emotional state of patients who are candidates for CAR-T therapy: Role of the advanced practice nurse

Introduction

CAR-T therapy is indicated in patients with refractory disease who usually present comorbidities, toxicities associated with previous treatments, and disease instability. Additionally, they must travel close to the infusion center, incurring financial and psychosocial costs. Our study aims to describe the quality of life and psycho-emotional state of candidates for CAR-T therapy.

Methods

An observational study was conducted from January to December 2022. The inclusion criteria were being 18 years or older, eligible for CAR-T therapy, and able to understand Spanish. Sociodemographic, clinical variables and Hospital Anxiety and Depression and quality of life scales were collected.

Results

One hundred and four participants were recruited, among them, seventy percent did not live in their usual residence. Seventy-five percent of the participants had depression, 76% anxiety, and 78% emotional function impairment. No statistically significant differences between the presence of anxiety/depression associated with not residing in their usual address (p 0.056) or receiving psychological care in their center of origin (p 0.583) were found. However, a correlation between the presence of anxiety/depression among participants referred to the psychology service by the Advanced Practice Nurse (APN) (p < 0.001) was found.

Conclusions

In conclusion, assessing the quality of life and psycho-emotional state of candidates for CAR-T therapy with validated scales allows us to identify candidates presenting anxiety and depression with the goal of improving the management of their emotional health. The APN's role is crucial in detecting complications and facilitating early referral to the psychology team.