TY - JOUR
T1 - Palliative Medicine Fellows' Discussions, Perceptions, and Training Regarding Medical Cannabis
AU - Sherry, Dylan R
AU - Patell, Rushad
AU - Han, Harry J
AU - Dodge, Laura E
AU - Braun, Ilana M
AU - Buss, Mary K
N1 - Publisher Copyright:
© 2024 American Academy of Hospice and Palliative Medicine
PY - 2024/6
Y1 - 2024/6
N2 - INTRODUCTION: Medical cannabis is increasingly considered for palliation of pain, nausea/vomiting, anorexia, and other symptoms. We aimed to determine whether training in hospice and palliative medicine (HPM) adequately prepares fellows to counsel patients about medical cannabis.METHODS: A previously validated questionnaire was adapted for HPM fellows. Domains included fellows' practices recommending cannabis and their knowledge of its effectiveness and risks compared with standard treatments. U.S. HPM fellowships were sent surveys in 2022 and 2023.RESULTS: 46 programs participated, 123 fellows responded (response rate of 42%) including 69% female; 55% White, and 28% Asian. Of respondents, 65% reported receiving formal training regarding medical cannabis; 57% reported discussing medical cannabis with over five patients; 23% recommended medical cannabis to more than five patients in the preceding year. Only 19%, however, felt sufficiently informed to issue cannabis-related recommendations. HPM fellows with prior training were not more likely to feel sufficiently informed to discuss cannabis (RR: 1.17; 95% CI: 0.82-1.66) or to recommend cannabis to patients (RR: 2.05, 95% CI: 0.89-4.71). Fellows rate cannabis as equally or more effective than conventional treatments for the following symptoms: anorexia/cachexia (63%), nausea/vomiting (43%), pain (25%), and neuropathic pain (21%).DISCUSSION: Most HPM fellows report formal training in the use of medical cannabis. Over half of trainees reported discussing medical cannabis with patients, but few considered themselves sufficiently informed to make cannabis-related clinical recommendations. These results suggest both a need for expanded high-quality evidence for medical cannabis in palliative care and for improved formal education for HPM fellows.
AB - INTRODUCTION: Medical cannabis is increasingly considered for palliation of pain, nausea/vomiting, anorexia, and other symptoms. We aimed to determine whether training in hospice and palliative medicine (HPM) adequately prepares fellows to counsel patients about medical cannabis.METHODS: A previously validated questionnaire was adapted for HPM fellows. Domains included fellows' practices recommending cannabis and their knowledge of its effectiveness and risks compared with standard treatments. U.S. HPM fellowships were sent surveys in 2022 and 2023.RESULTS: 46 programs participated, 123 fellows responded (response rate of 42%) including 69% female; 55% White, and 28% Asian. Of respondents, 65% reported receiving formal training regarding medical cannabis; 57% reported discussing medical cannabis with over five patients; 23% recommended medical cannabis to more than five patients in the preceding year. Only 19%, however, felt sufficiently informed to issue cannabis-related recommendations. HPM fellows with prior training were not more likely to feel sufficiently informed to discuss cannabis (RR: 1.17; 95% CI: 0.82-1.66) or to recommend cannabis to patients (RR: 2.05, 95% CI: 0.89-4.71). Fellows rate cannabis as equally or more effective than conventional treatments for the following symptoms: anorexia/cachexia (63%), nausea/vomiting (43%), pain (25%), and neuropathic pain (21%).DISCUSSION: Most HPM fellows report formal training in the use of medical cannabis. Over half of trainees reported discussing medical cannabis with patients, but few considered themselves sufficiently informed to make cannabis-related clinical recommendations. These results suggest both a need for expanded high-quality evidence for medical cannabis in palliative care and for improved formal education for HPM fellows.
KW - Adult
KW - Attitude of Health Personnel
KW - Fellowships and Scholarships
KW - Female
KW - Health Knowledge, Attitudes, Practice
KW - Humans
KW - Male
KW - Medical Marijuana/therapeutic use
KW - Palliative Care/methods
KW - Palliative Medicine/education
KW - Surveys and Questionnaires
KW - United States
UR - https://pubmed.ncbi.nlm.nih.gov/38417464/
UR - http://www.scopus.com/inward/record.url?scp=85188005178&partnerID=8YFLogxK
U2 - 10.1016/j.jpainsymman.2024.02.562
DO - 10.1016/j.jpainsymman.2024.02.562
M3 - Article
C2 - 38417464
SN - 0885-3924
VL - 67
SP - 471-477.e6
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 6
ER -