Pediatric oncology providers and use of medical marijuana in children with cancer.
Access At: http://mantis.link/4J53XVWNZ
Session Type and Session Title: Poster Session, Pediatric Oncology
Abstract Number: 10581
Poster Board Number: Board #272
Citation: J Clin Oncol 34, 2016 (suppl; abstr 10581)
Prasanna Janaki Ananth, Clement Ma, Hasan Al-Sayegh, Abby R. Rosenberg, Kelly Michelson, Leah Kroon, Victoria Klein, Claire M Wharton, Elise Hallez, Joanne Wolfe; Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, MA; Seattle Children’s Cancer and Blood Disorders Center, Seattle, WA; Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL
Background: Widespread state legalization of medical marijuana (MM) has increased access for children with serious illness. However, MM use remains controversial in pediatrics. Among children with cancer, MM may have a role in supportive care. We investigated provider perspectives on MM use in pediatric oncology patients.
Methods: A cross-sectional survey was sent electronically to 654 pediatric oncology providers at 3 National Cancer Institute-designated cancer centers in Illinois, Massachusetts, and Washington, where MM is legal. 313 (48%) responded; 301 (46%) were included in analyses. The 32-item survey elicited attitudes, practices, barriers, and awareness. Responses were analyzed descriptively.
Results: Median age of providers (59% nurses, 29% physicians, 10% physician-extenders) was 35 (range 22-70); 85% were female, and 88% were white. Almost all providers (92%) were willing to help pediatric cancer patients access MM. Most providers approved of oral MM formulations (90%) and of using MM to manage symptoms in pediatric oncology patients (92%). 88% of providers felt MM would be appropriate near the end of life, while far fewer (34%) felt it would be appropriate in the early stages of cancer treatment. Most were unconcerned about substance abuse among patients who receive MM (62%). Nearly one-third of providers (30%) received requests from patients or families for MM ≥ 1 time in the past month. Among providers receiving requests, 14% facilitated access. Nausea, anorexia, and pain were the most common symptoms for which MM was solicited. 46% cited the absence of standards around formulations, potency, or dosing to be the greatest barrier to recommending MM. Regarding awareness, a large majority of providers (86%) knew that their state had legalized MM. Fewer (58%) knew that MM is against federal laws, and only 5% knew state-specific regulations concerning access, possession, and cultivation.
Conclusions: Pediatric oncology providers hold predominantly favorable attitudes toward MM use in pediatric cancer patients. While MM inquiries are frequent among pediatric cancer patients and families in states where it is legal, more education is needed to increase provider awareness of state and federal regulations.