What role does medical cannabis play in treating symptoms experienced by palliative care patients?

Spencer N, Shaw E, Slaven M. Medical cannabis use in an outpatient palliative care clinic: A retrospective chart review. J Pain Manage 2016;9(4):507-513 Abstract

Why was this study conducted?

One of the potential uses for medical cannabis identified by Health Canada is to alleviate a variety of symptoms experienced by palliative care patients, such as pain, nausea, vomiting, lack of appetite, depression and insomnia. However, there’s little information about whether medical cannabis is being used for this purpose. To understand more about how medical cannabis is being used in palliative care, a retrospective review of patient charts was conducted at a pain and symptom management clinic in an academic tertiary healthcare centre in Ontario.

What does this study add?

Within the first year of the revised medical cannabis regulations in Canada, the number of outpatient palliative cancer patients prescribed the drug increased from less than 1% to 12.5%. The study found those prescribed cannabis tended to be male (62.8%), married (58.1%), living with a spouse or partner (55.8%), and between the ages of 51 and 74 years of age (74.4%). The most common symptom of those prescribed medical cannabis was pain (88.4%), with about half having moderate to severe pain. A number of other symptoms were recorded for patients prescribed medical cannabis (e.g., fatigue, lack of appetite, anxiety, and nausea) but significant proportions of records did not clearly indicate whether such symptoms were present or absent. A surprising finding was that 17 of the total pool of 43 patients (39.5%) reported they were already using cannabis when they joined the clinic. If the 24 patients whose previous cannabis use was not recorded are subtracted, then 17 out of 19 patients prescribed cannabis were already using it.

Is there anything else I should know?

The study was conducted by reviewing patient records and sometimes information of interest to the researchers was not captured. The study didn’t review the charts of patients not prescribed cannabis so it’s unknown whether the two groups were similar or different. The number of patients prescribed cannabis (n=43) was small and it’s unclear whether the people at this clinic are representative of most outpatient palliative care patients. The study was not designed to determine whether cannabis was effective in treating symptoms.