ANIMAL ASSISTED THERAPY: Efficiency, Process and Service Standards.

Recently SCAS held a seminar at Guy’s Hospital, London, for representatives of the medical profession, including doctors, nurses, clinical psychologists, physiotherapists and occupational therapists.

Access to animals can make people healthier.

Experts call for more research to convince doctors of the benefits.

Professor Sam Ahmedzai, Professor of Palliative Medicine at Sheffield University Medical School, and former Chair of SCAS, suggested that the potential health benefits of owning or having access to a pet animal are being under exploited for want of robust clinical data.

He said that therapeutic benefits had already been observed in numerous schemes where patients have bedside access to animals in hospitals and nursing homes.  This could be extended to many people, given the availability of good quality research on the topic to convince other doctors of the benefits.

Citing one small study of 18 people and their dogs, he described how the researcher had been able to demonstrate that time spent stroking and talking to the dogs resulted in subjects reducing their blood pressure, increasing levels of phenylethylamine and endorphin (the body’s natural mood-enhancing and pain-relieving chemicals) and decreasing levels of cortisol, a substance associated with stress.  A larger-sized study of this nature would help put animal assisted therapy on a more robust scientific footing, he suggested.

“There are already data from several small studies showing how human-pet interaction favourably impacts on levels of blood lipids, glucose and thrombotic factors as well as influencing the body’s own production of substances which boost the immune system, relieve pain and generate a sense of well-being, ” he remarked.

Professor Ahmedzai called for larger and more objective research to be carried out.  This would help persuade more hospitals to participate in schemes utilising the prophylactic and therapeutic health benefits of companion animals.  “Carefully designed studies at laboratory level could give us some of the answers as to how and why animals are good for our health,” he added.

Challenge of designing animal studies

Providing incontrovertible outcome data from animal studies presented a considerable challenge, he  acknowledged.  “The acme of medical research – Level 1 evidence – is the systematic review of large-scale double-blind,  randomised placebo-controlled trials.  Obviously such trials are inappropriate for evaluating
the health benefits of innovative programmes involving companion animals,” he pointed out.

Nevertheless, there are ways of providing high level prospective scientific data which would justify moves to get more hospitals to participate in animal-assisted therapy or to give patients access to visiting companion animals.  For example, researchers could be blinded to whether or not subjects owned a pet or participated in an animal-therapy programme.  They could then measure changes in numerous physiological or psychoneuro-immunological parameters over time as appropriate.

Most of the current database concerning animals and health is at Level 4 – derived from observational but uncontrolled studies – or at Level 5 – based on expert opinion.  While these yield valid knowledge and have been considered to be adequate justification by many healthcare professionals for introducing animals into
hospital wards, they are unfortunately not sufficiently strong to convince other hospitals or nursing homes that allowing patients access to animals is worthwhile;  or to influence GP’s to discuss the possibility of patients in suitable circumstances acquiring an appropriate pet.

“However, level 4 or 5 data is all that underpins much of current everyday medical practice not involving animals, and which is readily accepted,” he commented.

Animals impact favourably on cardiovascular risk factors

Some of the health claims for pet-ownership that have emerged to date from small, observational studies include the ability to slow down heart rate, lower blood pressure, decrease biochemical risk factors, reduce stress and speed up recovery from heart attacks.

Other studies suggest pet-owners consult their GP’s less frequently and require fewer hospital services. These claims need to be backed up by data showing the benefits truly stem from animals rather than an associated factor.

Psychosocial benefits accruing from access to animals have been documented in other research.  The presence of pets acts as a “social lubricant” or ice-breaker facilitating friendly interaction between individuals.  They help to socialise individuals with behavioural problems and simply, provide enormous quality of life benefits by bringing pleasure and companionship to patients with chronic diseases who may be isolated, disabled or unable to communicate.

“We need more data to help medics understand what elements of animal contact provide the benefits so they can design therapy programmes to incorporate them with confidence,” he concluded.

·        Visiting animal schemes involve volunteers taking their own animal usually into long-term residential care institutions such as nursing homes.  The intention is to provide patients with a focus of interest and    to give them the pleasure of handling animals.

·        In both these human-animal contact programmes, participants follow carefully designed guidelines to  ensure the health, safety and wellbeing of all concerned including the animals themselves.  The schemes  have been well received, with no associated risks or problems reported.