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

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.