scholarly journals So near yet so far: why won’t the UK prescribe medical cannabis?

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038687 ◽  
Author(s):  
David Nutt ◽  
Steve Bazire ◽  
Lawrence D Phillips ◽  
Anne Katrin Schlag
Keyword(s):  
Patient Reported Outcomes ◽  
Scientific Evidence ◽  
Evidence Base ◽  
Decision Makers ◽  
Medical Cannabis ◽  
Medicinal Use ◽  
Patient Reported ◽  
The Uk ◽  
Improve Patient ◽  
Gain Access

Although cannabis-based products for medicinal use are now legal in the UK, it is still challenging for patients to gain access, and only very few National Health Service prescriptions have been written to date. This paper attempts to make sense of why the UK lags behind so many other countries which also have legalised medical cannabis. From consulting with parents and patients, prescribers, pharmacists and decision-makers it seems that there are a series of distinct barriers to prescribing that need to be overcome in order to improve patient access to medical cannabis in the UK. These include concerns about the perceived lack of scientific evidence. To alleviate these concerns, we highlight the importance of patient-centred approaches including patient-reported outcomes, pharmacoepidemiology and n=1 trials, which can contribute to the development of the evidence base for medical cannabis. We hope that this paper will help policymakers and prescribers understand the challenges to prescribing and so help them develop approaches to overcome the current situation which is detrimental to patients.

scholarly journals Medical cannabis in the UK: From principle to practice

2020 ◽  
Vol 34 (9) ◽  
pp. 931-937
Author(s):  
Anne Katrin Schlag ◽  
David S Baldwin ◽  
Michael Barnes ◽  
Steve Bazire ◽  
Rachel Coathup ◽  
...  
Keyword(s):  
Medical Profession ◽  
Scientific Evidence ◽  
Evidence Base ◽  
Patient Survey ◽  
Chronic Illnesses ◽  
Medical Cannabis ◽  
Medical Problems ◽  
Patient Reported ◽  
Recent Patient ◽  
The Uk

Background: In the UK, medical cannabis was approved in November 2018, leading many patients to believe that the medicine would now be available on the NHS. Yet, to date, there have been only 12 NHS prescriptions and less than 60 prescriptions in total. In marked contrast, a recent patient survey by the Centre for Medical Cannabis (Couch, 2020) found 1.4 m people are using illicit cannabis for medical problems. Aims: Such a mismatch between demand and supply is rare in medicine. This article outlines some of the current controversies about medical cannabis that underpin this disparity, beginning by contrasting current medical evidence from research studies with patient-reported outcomes. Outcomes: Although definite scientific evidence is scarce for most conditions, there is significant patient demand for access to medical cannabis. This disparity poses a challenge for prescribers, and there are many concerns of physicians when deciding if, and how, to prescribe medical cannabis which still need to be addressed. Potential solutions are outlined as to how the medical profession and regulators could respond to the strong demand from patients and families for access to medical cannabis to treat chronic illnesses when there is often a limited scientific evidence base on whether and how to use it in many of these conditions. Conclusions: There is a need to maximise both clinical research and patient benefit, in a safe, cautious and ethical manner, so that those patients for whom cannabis is shown to be effective can access it. We hope our discussion and outlines for future progress offer a contribution to this process.

scholarly journals Exploring patient-reported outcomes of home-based cardiac rehabilitation in relation to Scottish, UK and European guidelines: an audit using qualitative methods

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024499 ◽  
Author(s):  
Hannah Ranaldi ◽  
Carolyn Deighan ◽  
Louise Taylor
Keyword(s):  
Cardiac Rehabilitation ◽  
Patient Reported Outcomes ◽  
Psychosocial Support ◽  
Daily Lives ◽  
Medical Risk ◽  
European Guidelines ◽  
Home Based ◽  
Patient Reported ◽  
The Uk ◽  
The Impact

ObjectivesThe Heart Manual (HM) is the UK’s leading facilitated home-based cardiac rehabilitation (CR) programme for individuals recovering from myocardial infarction and revascularisation. This audit explored patient-reported outcomes of home-based CR in relation to current Scottish, UK and European guidelines.SettingPatients across the UK returned their questionnaire after completing the HM programme to the HM Department (NHS Lothian).ParticipantsQualitative data from 457 questionnaires returned between 2011 and 2018 were included for thematic analysis. Seven themes were identified from the guidelines. This guided initial deductive coding and provided the basis for inductive subthemes to emerge.ResultsThemes included: (1) health behaviour change and modifiable risk reduction, (2) psychosocial support, (3) education, (4) social support, (5) medical risk management, (6) vocational rehabilitation and (7) long-term strategies and maintenance. Both (1) and (2) were reported as having the greatest impact on patients' daily lives. Subthemes for (1) included: guidance, engagement, awareness, consequences, attitude, no change and motivation. Psychosocial support comprised: stress management, pacing, relaxation, increased self-efficacy, validation, mental health and self-perception. This was followed by (3) and (4). Patients less frequently referred to (5), (6) and (7). Additional themes highlighted the impact of the HM programme and that patients attributed the greatest impact to a combination of all the above themes.ConclusionsThis audit highlighted the HM as comprehensive and inclusive of key elements proposed by Scottish, UK and EU guidelines. Patients reported this had a profound impact on their daily lives and proved advantageous for CR.

scholarly journals FRI0236 MIGHT A 12-WEEK AEROBIC EXERCISE INTERVENTION IMPROVE PATIENT-REPORTED OUTCOMES IN WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS?

2019 ◽  
Author(s):  
Blanca Gavilán Carrera ◽  
Jose Antonio Vargas-Hitos ◽  
Pablo Morillas-de-Laguno ◽  
Luis Manuel Saez-Uran ◽  
Antonio Rosales-Castillo ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Aerobic Exercise ◽  
Lupus Erythematosus ◽  
Patient Reported Outcomes ◽  
Exercise Intervention ◽  
Systemic Lupus ◽  
Patient Reported ◽  
Improve Patient

scholarly journals Patient-reported outcomes in meta-analyses --Part 2: methods for improving interpretability for decision-makers

2013 ◽  
Vol 11 (1) ◽  
pp. 211 ◽  
Author(s):  
Bradley C Johnston ◽  
Donald L Patrick ◽  
Kristian Thorlund ◽  
Jason W Busse ◽  
Bruno R da Costa ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Decision Makers ◽  
Patient Reported ◽  
Meta Analyses

scholarly journals Patient-reported outcomes in clinical practice

Hematology ◽  
2015 ◽  
Vol 2015 (1) ◽  
pp. 501-506 ◽  
Author(s):  
Sarah Dobrozsi ◽  
Julie Panepinto
Keyword(s):  
Clinical Practice ◽  
Patient Outcomes ◽  
Patient Reported Outcomes ◽  
Clinical Care ◽  
Patient Reported Outcome ◽  
Physician Communication ◽  
Valuable Data ◽  
Patient Reported ◽  
Improve Patient

Abstract Patient-reported outcome (PRO) measurement plays an increasingly important role in health care and understanding health outcomes. PROs are any report of a patient's health status that comes directly from the patient, and can measure patient symptoms, patient function, and quality-of-life. PROs have been used successfully to assess impairment in a clinical setting. Use of PROs to systematically quantify the patient experience provides valuable data to assist with clinical care; however, initiating use of PROs in clinical practice can be daunting. Here we provide suggestions for implementation of PROs and examples of opportunities to use PROs to tailor individual patient therapy to improve patient outcomes, patient–physician communication, and the quality of care for hematology/oncology patients.

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