Clinic-Based Animal-Assisted Intervention for Haemodialysis Patients' Treatment Adherence, Pain and Depression: An Interrupted Time Series Analysis

Abstract

Background

Maintaining adherence to one's haemodialysis regimen is paramount to overall health and well-being. The purpose of this study was to evaluate the feasibility and preliminary efficacy of a clinic-based animal-assisted intervention for improving patients' treatment adherence.

Methods

Using an interrupted time series analysis, this study examined the probability of unplanned missed haemodialysis treatment not due to hospitalization upon introducing therapy dog visits into the clinic, following a 3-month lead-in phase before dog exposure. An interrupted time series model was used to estimate the odds ratio (OR) of weekly non-adherence after dog exposure relative to pre-exposure adherence. Depression, anxiety and pain were secondary outcomes and were evaluated within-subjects based on self-reported ratings before and after each dog visit.

Results

Of the eligible clinic dialysis patients, 100% enrolled (17 of 17) and 82% (14 of 17) completed the study. The effect estimate for the reduction in probability of missing haemodialysis treatments following dog exposure phase compared to pre-exposure was OR 0.24 [95% CI: 0.09–0.62] (p = 0.003). Significant immediate mean reductions were also observed in self-reported pain (p = 0.004), depression (p = 0.029), anxiety (p = 0.019) and negative affect (p = 0.006).

Conclusion

As the first study to evaluate therapy dog visits as a treatment adherence intervention for patients receiving haemodialysis, findings indicate this animal-assisted intervention is feasible and well accepted by patients based on high rates of study engagement and low rates of dropout. Meaningful human-animal interaction in the clinic setting may provide motivation to avoid appointment no-shows.