A Survey of Hospice Professionals Regarding Medical Cannabis Practices

Costantino, Ryan C.; Felten, Natalee; Todd, Marisa; Maxwell, Terri L.; McPherson, Mary Lynn

doi:10.1089/jpm.2018.0535

Cited by 24 publications

(12 citation statements)

References 5 publications

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“…Some employees received education about medical marijuana, including indications, side-effects, drug interactions, monitoring parameters, legal issues, and proper disposal. 16 The results of the survey of hospice professionals were similar to the results of the survey in part I, reflecting that documentation of medical marijuana is inconsistent, most often listed in the medication profile or medication list. Findings in part III's retrospective chart review also echoed the hospice survey results of indications for symptoms management for medical marijuana use.…”

Section: Discussionsupporting

confidence: 60%

“…However, one existing publication by Consantino et al shares similar findings and concerns regarding medical marijuana use and documentation among hospice professionals using medical Cannabis. 16 The objectives of the study were to determine employees' comfort level with medical marijuana use in hospice, what processes and logistics hospice programs are employing, and to determine what, if any, education hospice programs are providing to their staff. The survey demonstrated 91% of respondents support medical marijuana use in hospice patients.…”

Section: Discussionmentioning

confidence: 99%

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Documentation of medical marijuana use in cancer patients

LeClair

Chamberlin

Clément

et al. 2019

J Oncol Pharm Pract

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Purpose Medical marijuana is often used as adjuvant therapy in cancer patients for symptom management, although limited evidence-based studies evaluating its efficacy or safety exist. Similar to over-the-counter medications, supplements, or herbal products, documentation of medical marijuana is important to monitor efficacy, potential adverse effects, or interactions. The objective of this quality improvement study was to improve the consistency of medical marijuana documentation in cancer patients by assessing current practices; educating healthcare team members about the importance of documentation and newly established documentation process; and evaluating the new documentation process. Methods This three-part quality improvement study was approved by the Institutional Review Board. In part I, a voluntary survey was sent via email to Cancer Center healthcare personnel to assess the current documentation process of medical marijuana. In part II, a best practice process for documenting medical marijuana in the electronic medical record was established. Medical marijuana was to be listed as a historical medication in the medication list. In-person and electronic education sessions were offered to Cancer Center clinical staff. The education emphasized the importance of documenting medical marijuana use and provided a detailed process for electronic medical record documentation. A pre- and post-test to assess understanding was also included. Part III was a retrospective chart review to evaluate documentation practices of certified medical marijuana users in the Cancer Center. Patients included in the study were greater than 18 years old and certified for medical marijuana use on or after 1 January 2018. Department of Corrections patients were excluded. Descriptive statistics were used for data analysis. Results The survey results in part I demonstrated a lack of consistency in the documentation of medical marijuana in the Cancer Center. The pre- and post-test scores measured in part II showed a significant improvement in understanding after education was provided. The average pre-test score was a 61 and post-test score was 88, indicating an average increase of 27 points. A larger increase in test scores was observed in those attending the in-person education than the online sessions ( p < 0.002). The results of the retrospective chart review in part III revealed 56 patients who met inclusion criteria, but only 39 patients were alive and evaluated at the time of the retrospective chart review. Of the 39 patients, 22 never completed the patient registration process and therefore, would never have been able to obtain medical marijuana. Seven patients had medical marijuana properly documented in their medication list and 10 patients were missing documentation in the medication list, showing room for improvement in documentation practices. Conclusions This quality improvement study led to the implementation of medical marijuana documentation in the medication list. Education increased healthcare team members understanding of medical marijuana utilization and the importance of documentation.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Documentation of medical marijuana use in cancer patients

LeClair

Chamberlin

Clément

et al. 2019

J Oncol Pharm Pract

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“…A recent survey of healthcare professionals in hospices in the United States identified that 40% of staff and volunteers have received no education about medical Cannabis. 82 Currently, there is very little, if any, teaching about Cannabis and cannabinoids on the curriculum for students of medicine, nursing and pharmacy in the United Kingdom. Part of the reason for that apparent deficiency is that curricula on those courses are already full with very high levels of contact time and a requirement for a detailed knowledge base.…”

Section: Barrier 7: Communicating the Knowledgebasementioning

confidence: 99%

Barriers to the wider adoption of medicinal Cannabis

Alexander

2020

British Journal of Pain

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The use of Cannabis-based preparations for medicinal use has waxed and waned in the multi-millennial history of human co-existence with the plant and its cultivation. Recorded use of preparations from Cannabis is effectively as old as recorded history with examples from China, India and Ancient Egypt. Prohibition and restriction of availability allowed a number of alternatives to take the place of Cannabis preparations. However, there has been a worldwide resurgence in medicinal Cannabis advocacy from the public. Media interest has been piqued by particular evocative cases. Altogether, therefore, there is pressure on healthcare professionals to prescribe and dispense Cannabis-based preparations. This review enunciates some of the barriers which are slowing the wider adoption of medicinal Cannabis.

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“…Moreover, acceptance of MM is widespread among oncology practitioners 2,7,18 . Yet, with limited empiric evidence to support use of MM, health care professionals may not feel sufficiently informed to make specific recommendations 2,7,19,20 . In our study, oncologists seldom initiated discussions about MM.…”

Section: Discussionmentioning

confidence: 85%

Parent and patient perceptions of medical marijuana in the childhood cancer context

Ananth

Revette

Reed-Weston

et al. 2020

Pediatric Blood & Cancer

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Background Medical marijuana (MM) is legal in 34 US jurisdictions. Yet, little is known about patient and parent perceptions of MM in pediatric cancer care. We examined attitudes, beliefs, and experiences regarding MM among parents of children with cancer and adolescent and young adult (AYA) patients, to help frame future research initiatives. Procedure In this qualitative study, we conducted semi‐structured, one‐on‐one interviews with parents and AYAs at a comprehensive cancer center. Interviews were audio‐recorded, transcribed, and coded using both descriptive and inductive coding approaches. We used content and framework analysis to identify key themes. Results Fifteen parents and 15 AYAs enrolled. Participants were generally receptive to MM use, concurrently weighing benefits and risks. Participants most often endorsed MM use for relief of nausea, anorexia, and pain. Simultaneously, participants identified concerns about MM, including potential physiologic and psychological effects on children and lack of research. However, concerns were frequently minimized, relative to chemotherapy or supportive care medications with perceived greater side effect profiles. Many participants expressed uncertainty regarding legal access, citing complex processes to obtain MM. Few participants had discussed MM with their oncologist, instead seeking guidance from the internet, family, or peers. Importantly, we elicited several misconceptions regarding MM, including its utility as cancer‐directed therapy. Conclusion Patients and families are receptive to using MM, motivated by potential for symptom relief and cancer‐directed effects. Yet, lack of empiric evidence is a barrier, underscoring the need for robust clinical trial data to support MM recommendations and use.

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A Survey of Hospice Professionals Regarding Medical Cannabis Practices

Cited by 24 publications

References 5 publications

Documentation of medical marijuana use in cancer patients

Documentation of medical marijuana use in cancer patients

Barriers to the wider adoption of medicinal Cannabis

Parent and patient perceptions of medical marijuana in the childhood cancer context

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