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Kidney Week

Abstract: FR-PO440

Animal-Assisted Intervention for Hemodialysis Patients' Treatment Adherence, Pain, and Depression

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Stensland, Meredith L., The University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
  • Elorriaga, Adrian E., US Renal Care Inc, San Antonio, Texas, United States
  • Block, Martha, US Renal Care Inc, San Antonio, Texas, United States
  • Block, Geoffrey A., US Renal Care Inc, San Antonio, Texas, United States
  • Mcgeary, Don Douglas, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
  • Flaman, Jacie, The University of Texas at San Antonio, San Antonio, Texas, United States
Background

Maintaining adherence to one’s hemodialysis [HD] regimen is paramount to patients’ health and well-being. The purpose of this pilot study was to evaluate the feasibility of a clinic-based animal-assisted intervention [AAI] for improving HD patients’ treatment adherence, depression, and pain.

Methods

This study used a within-subject repeated measures design at 1 outpatient HD clinic with a primary outcome of unplanned missed HD treatments. Participants were prevalent HD patients, age 18+, who had depression (PHQ-2 ≥ 3), and chronic pain (Pain Enjoyment General activity score ≥ 4). Patients were randomized 1:1 into 2 groups: 1 dog visit (AAI1) or 2 dog visits (AAI2) per week for 10 weeks. The AAI took place in the waiting room immediately prior to HD; it involved socializing with and petting the dog. Patients completed pain and mood assessments before and after each dog visit. A generalized linear mixed effects model was used for data analysis.

Results

A total of 17 patients were enrolled (n= 8 AAI1, n=9 AAI2) who cumulatively received 199 of 240 possible dog visits (83%), averaging 10.8 ± 4.8 minutes each. There were 9 missed HD treatments during the trial (1 in AAI1, 8 in AAI2), while there were 30 missed treatments in the 12 weeks prior to trial (6 in AAI1, 24 in AAI2). All patients who missed at least 1 HD treatment in the 12 weeks pre-enrollment had a decrease of at least 1 fewer missed treatments during the trial. The effect estimate for the reduction in probability of missing an HD treatment in the AAI vs pre-trial was OR 0.23 (95% CI: 0.09 to 0.57), p = 0.002. Pain severity rated 0-10 scores: pre-test = M 4.38 ± 2.63, post-test = M 3.46 ±1.93 (AAI1); pre-test = M 3.52 ± 1.91, post-test = M 3.14 ±2.04 (AAI2).

Conclusion

Including therapy dogs in HD patients’ healthcare routine may offer a complementary approach to improving outcomes. This safe and resource-minimal intervention received high patient approval and provides insight for determining the treatment effect of AAI in order to design larger controlled clinical trials on the clinical effectiveness of AAI.