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Experiences, patient interactions and knowledge regarding the use of cannabis as a medicine in a cohort of New Zealand doctors in an oncology setting
  1. Karen Oldfield1,2,
  2. Allie Eathorne1,
  3. Jordan Tewhaiti-Smith1,
  4. Richard Beasley1,2,
  5. Alex Semprini1,2,
  6. Irene Braithwaite2
  1. 1 Medical Research Institute of New Zealand, Wellington, New Zealand
  2. 2 School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand
  1. Correspondence to Karen Oldfield, Medical Research Institute of New Zealand, Private Bag 7902, Newtown, Wellington 6242, New Zealand; Karen.Oldfield{at}mrinz.ac.nz

Abstract

Purpose of Study To explore the experiences, patient interactions and knowledge regarding the use of cannabis as a medicine in New Zealand doctors in an oncology setting.

Study Design An observational cross-sectional survey undertaken between November 2019 and January 2020 across four secondary-care hospital oncology departments within New Zealand (Auckland, Wellington, Christchurch and Dunedin). Participants were a convenience sample of doctors; consultants, registrars, medical officers of special status and house surgeons working in oncology departments. Of 53 individuals approached, 45 participated (85% Response Rate). The primary outcome was reporteddoctor-patient interactions. Secondary outcomes included knowledge of cannabis-based products, their efficacy, prescribing regulations and educational access.

Results Of 44 doctors, 37 (84%, 95% CI: 70 to 93) reported patient requests to prescribe cannabis-based products and 43 (98%, 95% CI: 88 to 100) reported patients using illicit cannabis for medical symptoms. Primary request reasons were pain, nausea/vomiting and cancer treatment. 33/45 (73%, 95% CI: 58 to 85) cited knowledge of at least one cannabis-based product and 27/45 (60%, 95% CI: 44 to 74) indicated at least one condition that had evidence of efficacy. 36/44 (82%, 95% CI: 67 to 92) expressed future prescribing concerns but all were willing to use a cannabis-based product developed with traditional medical provenance.

Conclusion In the oncology setting, patients are asking doctors about symptomatic and curative treatment with cannabis-based products. Doctors are not biased against the use of products showing medical provenance; however, NZ-specific clinical and regulatory guidelines are essential to support patient discussions and appropriate prescribing.

  • Oncology
  • chemotherapy
  • pain management
  • complementary medicine
  • education & training (see medical education & training)

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Footnotes

  • Contributors KO, IB, AS and RB planned the study. KO and JT-S conducted the surveys. KO and AE conducted the data analysis. KO drafted the manuscript. AE, JT-S, AS, RB and IB reviewed the manuscript. KO submitted the manuscript. KO is responsible for the overall content as guarantor.

  • Funding Funding for this study was provided through the HRC Clinical Research Training Fellowship [Grant number: 20/057]. The Medical Research Institute of New Zealand is funded by the HRC by way of an Independent Research Organisation (IRO) grant [Grant number: 18/002]. The funding organisations did not have a role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

  • Competing interests KO declares that she has received funding through a Clinical Research Training Fellowship from the Health Research Council of New Zealand (HRC). IB, AS and KO are members of the Medical Cannabis Research Collaborative (NZ), an impartial collaboration of academics and regulatory experts with an interest in research into the use of cannabis as a medicine. AE, JT-S and RB have no competing interests to declare. The Medical Research Institute of New Zealand is funded by the HRC by way of an Independent Research Organisation (IRO) grant. The Medical Research Institute of New Zealand has undertaken unrelated consultant work for Helius Therapeutics, Whakaora Pharma, RuaBio and ZHM.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Karen Oldfield reports that she had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Karen Oldfield, Medical Research Institute of New Zealand and Victoria University of Wellington and Allie Eathorne, Medical Research Institute of New Zealand conducted and are responsible for data analysis. A copy of the questionnaire response data set is available on request. Please contact Karen.Oldfield@mrinz.ac.nz to request this.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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