Clinical Conditions and Prescription Drug Utilization among Early Medical Marijuana Registrants in Florida

Medical Cannabis Use and Its Impact on Health Among Older Adults: Recent Research Findings and Future Directions

Purpose of Review

With the rapidly changing landscape of state level legalization of cannabis, older adults have become one of the fastest growing populations seeking medical cannabis (MC). However, research evidence on the risks and benefits of MC use in this population remains limited. This review aims to synthesize recent literature on the impacts of MC use in older adults and identify critical knowledge gaps to be addressed in future research.

Recent Findings

Recent literature showed that older adults often face financial and/or educational barriers and stigma associated with MC access. Emerging data showed that MC may have therapeutic effects on symptoms of conditions such as chronic pain, insomnia, anxiety/depression, dementia, nausea, and vomiting. However, available evidence is inconsistent and tends to rely on self-report and uncontrolled studies. While some adverse events associated with MC use were reported, it is generally well tolerated in older adults. Neurocognitive and psychological consequences and cardiovascular risks have been reported but again only in limited studies with inconsistent findings.

Summary

There is a need for more systematic and rigorous research on MC in older adults to determine its safety and efficacy. Research on dosing procedures and product characteristics, as well as how these may impact health outcomes, is crucial. More consistent evidence is needed to inform policy changes and patient/physician education to minimize potential risks and optimize benefits among older adults seeking MC as an alternative treatment.

Healthcare professionals' perspectives on the use of medicinal cannabis to manage chronic pain: A systematic search and narrative review

RATIONALE, AIMS, AND OBJECTIVES

Chronic pain is a global public health problem that negatively impacts individuals' quality of life and imposes a substantial economic burden on societies. The use of medicinal cannabis (MC) is often considered by patients to help manage chronic pain as an alternative or supplement to more conventional treatments, given enabling legalization in a number of countries. However, healthcare professionals involved in providing guidance for patients related to MC are often doing so in the absence of strong evidence and clinical guidelines. Therefore, it is crucial to understand their perspectives regarding the clinical use and relevance of MC for chronic pain. As little is known about attitudes of HCPs with regard to MC use for chronic pain specifically, the aim of this review was to identify and synthesize the published evidence on this topic.

METHODS

A systematic search was conducted across six databases: MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, and PubMed from 2001 to March 26, 2021. Three authors independently performed the study selection and data extraction. Thematic analysis was undertaken to identify key themes.

RESULTS

A total of 26 studies were included, involving the United States, Israel, Canada, Australia, Ireland, and Norway, and the perspectives of physicians, nurses, and pharmacists. Seven key themes were identified: MC as a treatment option for chronic pain, and perceived indicated uses; willingness to prescribe MC; legal issues; low perceived knowledge and the need for education; comparative safety of MC versus opioids; addiction and abuse; and perceived adverse effects; CONCLUSION: To support best practice in the use of MC for chronic pain, healthcare professionals require education and training, as well as clinical guidelines that provide evidence-based information about efficacy, safety, and appropriate dosage of products for this indication. Until these gaps are addressed, healthcare professionals will be limited in their capacity to make treatment recommendations about MC for people/patients with chronic pain.

Academic-industry partnership advancing cannabis science: A Complementary Care Practice-Based Research Network

OBJECTIVES

Data collected during routine care holds the potential to support hypothesis generation, study feasibility, and provide insight regarding how to address problems under real world conditions. Currently there are no practice-based research networks in Florida that focus on complementary care in general or medical marijuana specifically. Through an academic-industry partnership, we sought to develop a practice-based research network focused on cannabis science and create a de-identified database for analyses that support hypothesis generation, study feasibility estimation, and a network that also facilitates recruitment into future research studies.

DESIGN

The Complementary Care Practice-Based Research Network (CC-PBRN) is a centralized repository, which contains electronic health records (EHR) from a private medical cannabis health system in the state of Florida.

RESULTS

This paper provides cross-sectional descriptive analyses of the CC-PBRN's 43,802 currently active patients. There are 24 clinics in the network with nine in North Florida, 11 in Central Florida, and 4 in South Florida.

CONCLUSION

This network serves as a statewide resource for patient-reported outcomes (PRO) research in medical marijuana. The network currently has numerous outpatient practices with thousands of patients that are a potential source of research participants for both observational studies as well as traditional clinical trials. The outpatient clinical practices can also serve as units of analysis for pragmatic trials comparing different care protocols and organizational structure.