scholarly journals Medical cannabis and epilepsy in the UK – A qualitative analysis of the carers’ perspective: “We're asking for quality of life for our children”

2021 ◽  
Vol 7 ◽  
pp. 205032452110349
Author(s):  
Anne Katrin Schlag ◽  
Rayyan Zafar ◽  
David Nutt
Keyword(s):  
Patient Relationship ◽  
Medicinal Products ◽  
Medical Cannabis ◽  
Childhood Onset ◽  
Political Issues ◽  
Financial Costs ◽  
Per Se ◽  
Trust And Power ◽  
The Uk

Despite the legalisation of cannabis based medicinal products (CBMPs) in the UK in November 2018, today there remains a scarcity of NHS prescriptions, and many patients continue to face unsustainable financial costs to acquire their medicines. Following on from our previous quantitative study highlighting the effectiveness of CBMPs to treat severe intractable childhood-onset epilepsy, for the present study, we used a narrative, open-ended approach to interview parents/carers of these patients. 11 families were interviewed to understand their current situation in more depth, and to contextualise the previous findings. Although these families have found CBMPs to be the most effective treatment for their child’s condition, access to these medicines remains severely restricted, causing serious challenges in their day-to-day life. Participants discussed a broad range of issues associated with medical cannabis. These included the regulation and policy surrounding medical cannabis, the anger and desperation related to these policies, and the benefits and harms of it. Evidently, the benefits of medical cannabis for these patients far outweigh any associated risks. Many of the issues raised in our study go beyond the science of medical cannabis per se. Rather, they are political issues, related to the wider issue of trust and power in society, and associated challenges of the doctor and patient relationship. The findings highlight the importance of including patients in decision-making about their medical plans and the value that should be given to their reported outcomes and wishes. We conclude by offering implications for further research and for policy making so that these families, and others like them, can finally receive the medications they so urgently require without crippling financial costs.

scholarly journals UK Medical Cannabis Registry palliative care patients cohort: initial experience and outcomes

2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Devaki Nimalan ◽  
Michal Kawka ◽  
Simon Erridge ◽  
Mehmet Ergisi ◽  
Michael Harris ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Adverse Events ◽  
Symptom Control ◽  
Case Series ◽  
Nausea And Vomiting ◽  
Medical Cannabis ◽  
Patient Reported ◽  
The Uk

Abstract Introduction Palliative care aims to improve quality of life through optimal symptom control and pain management. Cannabis-based medicinal products (CBMPs) have a proven role in the treatment of chemotherapy-induced nausea and vomiting. However, there is a paucity of high-quality evidence with regards to the optimal therapeutic regimen, safety, and effectiveness of CBMPs in palliative care, as existing clinical trials are limited by methodological heterogeneity. The aim of this study is to summarise the outcomes of the initial subgroup of patients from the UK Medical Cannabis Registry who were prescribed CBMPs for a primary indication of palliative care, cancer pain and chemotherapy-induced nausea and vomiting, including effects on health-related quality of life and clinical safety. Methods A case series from the UK Medical Cannabis Registry of patients, who were receiving CBMPs for the indication of palliative care was undertaken. The primary outcome consisted of changes in patient-reported outcome measures including EQ-5D-5L, General Anxiety Disorder-7 (GAD-7), Single-Item Sleep Quality Scale (SQS), Pain Visual Analog Scale (VAS) and the Australia-Modified Karnofsky Performance Scale at 1 and 3 months compared to baseline. Secondary outcomes included the incidence and characteristics of adverse events. Statistical significance was defined by p-value< 0.050. Results Sixteen patients were included in the analysis, with a mean age of 63.25 years. Patients were predominantly prescribed CBMPs for cancer-related palliative care (n = 15, 94%). The median initial CBD and THC daily doses were 32.0 mg (Range: 20.0–384.0 mg) and 1.3 mg (Range: 1.0–16.0 mg) respectively. Improvements in patient reported health outcomes were observed according to SQS, EQ-5D-5L mobility, pain and discomfort, and anxiety and depression subdomains, EQ-5D-5L index, EQ-VAS and Pain VAS validated scales at both 1-month and 3-months, however, the changes were not statistically significant. Three adverse events (18.75%) were reported, all of which were either mild or moderate in severity. Conclusion This small study provides an exploratory analysis of the role of CBMPs in palliative care in the first cohort of patients since CBMPs legalisation in the UK. CBMPs were tolerated with few adverse events, all of which were mild or moderate and resolved spontaneously. Further long-term safety and efficacy studies involving larger cohorts are needed to establish CBMPs role in palliative care, including comparisons with standard treatments.

scholarly journals Ending the pain of children with severe epilepsy? An audit of the impact of medical cannabis in 10 patients

2020 ◽  
Vol 6 ◽  
pp. 205032452097448
Author(s):  
RR Zafar ◽  
AK Schlag ◽  
DJ Nutt
Keyword(s):  
Seizure Frequency ◽  
Case Series ◽  
Primary Objective ◽  
Medical Cannabis ◽  
Whole Plant ◽  
Ease Of Access ◽  
Financial Burdens ◽  
The Uk ◽  
The Impact

Background Scientific and anecdotal evidence suggest that whole plant cannabis extracts are effective in reducing seizure frequency in individuals with a range of epileptic etiologies. We report a case series of 10 individuals using CBMPs in the UK to treat their conditions. Methods In this retrospective study, we report on patients (aged 2-48) with severe, intractable, childhood onset epilepsies using combined cannabinoid therapy. Carers of patients provided details through the charity ‘End our Pain’ and these data were subsequently analysed. Our primary objective was to assess changes in monthly seizure frequency pre and post initiation of CBMPs. We also report on previous and current AED, CBD:THC daily dose, quality of life and financial costs associated with CBMP private prescription. Change in monthly seizure frequency were assessed using a Wilcoxon Signed-ranks test. Results Of the 10 patients enrolled in the study there was an 97% mean reduction in monthly seizure frequency post initiation of CBMPs which was statistically significant (Z = 0, p < 0·01). We showed a reduction in AED use following initiation of CBMPs from a mean of 8 (±5·98) to 1 (±1·05). All patients were using either Bedrolite or Bedica (Bedrocan International) as their CBMP. Individual daily doses of THC ranged from 6·6mg – 26·5mg and for CBD, 200 mg – 550 mg. Average monthly cost of CBMP was £1816·20. Interpretation Our findings suggest a combination of CBD and THC based products are effective in reducing seizure frequency in a range of epileptic conditions. We highlight the inefficacy of the healthcare system in supporting these patients who bare great personal and financial burdens. We encourage specialist physicians and relevant bodies to permit greater ease of access of these medications to those patients where efficacy has been shown.

Assessments of User Comments With “Alternative Views” as a Function of Media Trust

2020 ◽  
pp. 1-12
Author(s):  
Marlene Kunst
Keyword(s):  
Online Discussions ◽  
Future Research ◽  
Political Issues ◽  
Argument Quality ◽  
The Public ◽  
Mainstream Media ◽  
User Comments ◽  
Media Trust ◽  
Heuristic Information Processing

Abstract. Comments sections under news articles have become popular spaces for audience members to oppose the mainstream media’s perspective on political issues by expressing alternative views. This kind of challenge to mainstream discourses is a necessary element of proper deliberation. However, due to heuristic information processing and the public concern about disinformation online, readers of comments sections may be inherently skeptical about user comments that counter the views of mainstream media. Consequently, commenters with alternative views may participate in discussions from a position of disadvantage because their contributions are scrutinized particularly critically. Nevertheless, this effect has hitherto not been empirically established. To address this gap, a multifactorial, between-subjects experimental study ( N = 166) was conducted that investigated how participants assess the credibility and argument quality of media-dissonant user comments relative to media-congruent user comments. The findings revealed that media-dissonant user comments are, indeed, disadvantaged in online discussions, as they are assessed as less credible and more poorly argued than media-congruent user comments. Moreover, the findings showed that the higher the participants’ level of media trust, the worse the assessment of media-dissonant user comments relative to media-congruent user comments. Normative implications and avenues for future research are discussed.

Modernization of Antimonopoly Policy in Russia (Economic Analysis of Proposed Changes in the Competition Law)

2005 ◽  
pp. 100-116
Author(s):  
S. Avdasheva ◽  
A. Shastitko
Keyword(s):  
Economic Analysis ◽  
Financial Markets ◽  
Financial Services ◽  
Competition Law ◽  
Commodity Markets ◽  
State Aid ◽  
Executive Power ◽  
Rule Of Reason ◽  
Per Se

The article is devoted to the analysis of the draft law "On Protection of Competition", which must substitute the laws "On Competition and Limitation of Monopolistic Activity on Commodity Markets" and "On Protection of Competition on the Financial Services Market". The innovations enhancing the quality of Russian competition law and new norms providing at least ambiguous effects on antimonopoly regulation are considered. The first group of positive measures includes unification of competition norms for commodity and financial markets, changes of criteria and the scale of control of economic concentrations, specification of conditions, where norms are applied "per se" and according to the "rule of reason", introduction of rules that can prevent the restriction of competition by the executive power. The interpretation of the "collective dominance" concept and certain rules devoted to antimonopoly control of state aid are in the second group of questionable steps.

Quality of medicinal products: the crux of the problem and foreign experience

2014 ◽  
pp. 14-24 ◽  
Author(s):  
A.N. Vasilyev ◽  
◽  
L.A. Reutskaya ◽  
S.A. Baidullaeva ◽  
D.V. Goryachev ◽  
...  
Keyword(s):  
Medicinal Products ◽  
Foreign Experience

scholarly journals Cannabis Use among Older Persons with Arthritis, Cancer and Multiple Sclerosis: Are We Comparing Apples and Oranges?

2021 ◽  
Vol 11 (5) ◽  
pp. 532
Author(s):  
Brian Kaskie ◽  
Hyojung Kang ◽  
Divya Bhagianadh ◽  
Julie Bobitt
Keyword(s):  
Multiple Sclerosis ◽  
Older Persons ◽  
Behavioral Outcomes ◽  
Cannabis Use ◽  
Medical Cannabis ◽  
Opioid Use ◽  
Quality Of Sleep ◽  
Impact Processes ◽  
Lower Baseline

Although researchers have identified medications that relieve symptoms of multiple sclerosis (MS), none are entirely effective and some persons with multiple sclerosis (PwMS) use alternatives. Our study compared cannabis use among PwMS (N = 135) and persons diagnosed with arthritis (N = 582) or cancer (N = 622) who were age 60 and older, enrolled in the State of Illinois Medical Cannabis Program, and invited to complete a survey fielded between June and September, 2019. We used logistic regression to identify significant differences in self-reported effects of cannabis on psychological wellbeing, quality of life, and three behavioral outcomes, and we also considered effects of past year opioid use relative to these outcomes. We found that the majority of individuals from all groups used cannabis to address pain and improve quality of sleep. While PwMS reported lower baseline levels across all five outcomes, we found that the reported effects of cannabis were largely comparable across the groups. We also found that cannabis benefitted persons with sleep and digestive issues regardless of condition, whereas persons who used opioids in addition to cannabis were less likely to experience an improvement in any of the outcomes. This comparative evaluation suggests that cannabis’ effects are not specific to MS, arthritis, or cancer as much as they impact processes common among these distinct conditions. We also found evidence that cannabis may be a viable alternative to opioids for those with these conditions and experiencing pain.

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