Controlled clinical trial of canine therapy versus usual care to reduce patient anxiety in the emergency department

Abstract

Objective: Test if therapy dogs reduce anxiety in emergency department (ED) patients.

Methods: In this controlled clinical trial (NCT03471429), medically stable, adult patients were approached if the physician believed that the patient had "moderate or greater anxiety." Patients were allocated on a 1:1 ratio to either 15 min exposure to a certified therapy dog and handler (dog), or usual care (control). Patient reported anxiety, pain and depression were assessed using a 0-10 scale (10 = worst). Primary outcome was change in anxiety from baseline (T0) to 30 min and 90 min after exposure to dog or control (T1 and T2 respectively); secondary outcomes were pain, depression and frequency of pain medication.

Results: Among 93 patients willing to participate in research, 7 had aversions to dogs, leaving 86 (92%) were willing to see a dog six others met exclusion criteria, leaving 40 patients allocated to each group (dog or control). Median and mean baseline anxiety, pain and depression scores were similar between groups. With dog exposure, median anxiety decreased significantly from T0 to T1: 6 (IQR 4-9.75) to T1: 2 (0-6) compared with 6 (4-8) to 6 (2.5-8) in controls (P<0.001, for T1, Mann-Whitney U and unpaired t-test). Dog exposure was associated with significantly lower anxiety at T2 and a significant overall treatment effect on two-way repeated measures ANOVA for anxiety, pain and depression. After exposure, 1/40 in the dog group needed pain medication, versus 7/40 in controls (P = 0.056, Fisher's exact test).

Conclusions: Exposure to therapy dogs plus handlers significantly reduced anxiety in ED patients.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Consort flow diagram.

Flow diagram of patients approached for participation *Reasons for voluntary withdrawal: 1. Patient was worried that police would come in with the dog; 2. Likes dogs, but not for her. Thinks therapy dogs would help people though; 3.Goes to therapy every other week and there is a dog there, but didn't want to see one today.

Fig 2. Main findings.

Comparison of median and interquartile ranges (top and bottom of boxes) and 90th percential ranges (whiskers) of patient reported anxiety, pain and depression reported by patients assigned in a 1:1 ratio to a therapy dog plus handler (+Dog) or usual care (No Dog). T0 was measured at baseline prior to exposure; T1 was at 30 min after exposure, and T2 was made approximately one hour later. *P<0.05 by Unpaired t-test and Mann-Whitney U at the time point). All three measurements (anxiety, pain and depression) were significantly different for treatment effect (Dog vs. No Dog) by repeated measures analysis of variance).