Introduction :
Medicinal cannabis (MC) has been prescribed using Special Access Scheme (SAS) and Authorised Prescriber Scheme (APS) for the past 5 years. It is primarily prescribed for refractory cancer and cancer related symptoms in the form of an oil with varying cannabinoid profiles. As with all new medications and therapies evaluation of practice is essential to safe and effective development and reflection of prescribing, prescribing patterns.
Method :
A retrospective evaluation of prescribing of one practitioner was carried out to identify : products prescribed, demographic of patients prescribed MC and their care needs and concerns. This evaluation was of all products prescribed to cancer patients in a single institution between 07/2017 - 09/2021 .
Results:
Between the period of 07/2017 - 09/2021, 412 applications were made for approval of MC via SAS category B. Patient age ranging from 17-87. Average days required for approval improved over time from 20 (07/2017) to 1 (09/2021) The majority, 228 (55%) were for cancer and cancer related symptoms (general category) with 62 (15%) for anorexia only, 33 (8%) for Chemotherapy-induced Nausea and vomiting (CINV). The most commonly prescribed products were THC 10mg/ml : CBD 10mg/ml whole plant balanced oil products, followed by a 2:1 CBD dominant product and CBD dominant full spectrum products with ≤1mg/ml THC. Patients were primariliy in the outpatient setting but also prescribed and administered in the inpatient setting.
Patient satisfaction, perceived benefit, change in symptom scores over time is currently in the process of evaluation.
Conclusion :
The safe prescribing of MC, as with all new drugs and therapies is essential to the integration of therapy into standard of care. Embedding research ,retrospective reviews and symptom scores whilst working closely with pharmacy team enables the progression of the integration of medicinal cannabis into symptom management in cancer patients .