By | October 18, 2019

Marijuana has been used for thousands of years for both medicinal and religious purposes by cultures all over the world. Medical marijuana, also known as medical cannabis (MC), has been legalized in a growing number of states and is useful for many symptoms experienced at the end of life, such as pain, muscle spasms, anorexia and nausea/vomiting.  Despite widespread use, MC is not legal at the federal level. Hospices, through the Hospice Medicare Benefit, are largely funded with federal dollars, creating uncertainty and variability in how requests for MC are handled among hospice professionals.

“A Survey of Hospice Professionals Regarding Medical Cannabis Practices,” co-conducted by clinicians at Enclara Pharmacia and the University of Maryland, Baltimore, and recently published in the online Journal of Palliative Medicine, set out to uncover attitudes on this subject among hospice professionals across the country.

Gathering Data

Designed to determine respondents’ comfort level with MC use in hospice, the survey examines what processes and logistics hospice programs are employing when dealing with MC, and determines what, if any, education hospice programs are providing to their staff.

At the time that this survey was conducted, plant-based cannabis was legal for medical use in 33 of 50 U.S. states and the District of Columbia. The research team tested the survey for errors and made revisions through a collaborative process. The instrument consisted of a series of multiple-choice questions with opportunities for free text commentary.

Overwhelming Results

According to respondents, 91 percent support MC use for hospice patients. However, those same respondents reported that it is rare for hospice physicians to register as an MC practitioner in their practice state to issue certifications to patients and provide recommendations.

Eighty-four percent of respondents believed health care professionals would benefit from standardized protocols to better manage MC in their organizations, especially because it is common for patients or family members to inquire about MC, with 90 percent saying they have fielded questions from patients.

According to respondents, MC is mostly successful in reducing nausea/vomiting, pain, and anxiety. Despite these benefits, for now, barriers to MC use in hospice care include discordant legal status between state and federal governments, questions about clinical efficacy and safety, lack of access, regulatory concerns, misinformation, and other societal factors.

Nevertheless, hospice staff overwhelmingly support patient access to MC. Furthermore, those who practice in states where MC is not yet legal wish that it was. In order to better understand how MC could one day be commonly used in hospice, additional policies, regulations, education, and resources are needed.

Learn More

If you are interested in learning more about medical marijuana and its use in hospice, view our educational webinar.

Additionally, you can view the full Journal of Palliative Medicine article, “A Survey of Hospice Professionals Regarding Medical Cannabis Practices,” authored by Ryan C. Costantino, Natalee Felten, Marisa Todd, Terri Maxwell and Mary Lynn McPherson, here.

 

Special Thanks to These Authors For Contributing to This Post

Ryan Constantino, PharmD, BCPS, BCGP
Director of Pharmacy Clinical Decision Support, Defense Health Agency

Terri Maxwell Ph.D, APRN
Chief Clinical Officer, Turn-Key Health

Mary Lynn McPherson, PharmD, MA, MDE, BCPS, CPE
Professor and Executive Director, Advanced Post-Graduate Education in Palliative Care in the Department of Pharmacy Practice and Science at the University of Maryland School of Pharmacy in Baltimore

Natalee Felten, PharmD, BCPS
Managed Care Clinical Pharmacist, PerformRx

Marisa Todd, PharmD, BCPS

Marisa Todd, PharmD, BCPS, is the Director of Clinical Education at Enclara Pharmacia. Marisa earned her doctor of pharmacy degree at Wilkes University, Nesbitt School of Pharmacy. She completed a 1-year post-graduate pharmacy practice residency program and maintains certification as a Board Certified Pharmacotherapy Specialist (BCPS).

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