Clinical trials of medicinal cannabis for appetite-related symptoms from advanced cancer: a survey of preferences, attitudes and beliefs among patients willing to consider participation

T Luckett; J Phillips; N Lintzeris; D Allsop; J Lee; N Solowij; J Martin; L Lam; R Aggarwal; N McCaffrey; D Currow; R Chye; M Lovell; I McGregor; M Agar

doi:10.1111/imj.13224

Clinical trials of medicinal cannabis for appetite-related symptoms from advanced cancer: a survey of preferences, attitudes and beliefs among patients willing to consider participation

Intern Med J. 2016 Nov;46(11):1269-1275. doi: 10.1111/imj.13224.

Authors

T Luckett¹, J Phillips², N Lintzeris^{3

4}, D Allsop⁵, J Lee⁶, N Solowij⁷, J Martin⁸, L Lam², R Aggarwal⁹, N McCaffrey¹⁰, D Currow¹⁰, R Chye¹¹, M Lovell^{12

13}, I McGregor¹⁴, M Agar^{2

15

16}

Affiliations

¹ Centre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia. tim.luckett@uts.edu.au.
² Centre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
³ Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, Sydney, New South Wales, Australia.
⁴ Drug and Alcohol Services, South East Sydney Local Health District, NSW Health, Sydney, New South Wales, Australia.
⁵ School of Psychology, The University of Sydney, Sydney, New South Wales, Australia.
⁶ Palliative Care, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
⁷ School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia.
⁸ Department of Clinical Pharmacology, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
⁹ Palliative Care, Liverpool Cancer Therapy Centre, Liverpool Hospital, Sydney, New South Wales, Australia.
¹⁰ Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia.
¹¹ Sacred Heart Supportive and Palliative Care, St Vincent's Hospital, Sydney, New South Wales, Australia.
¹² Palliative Care, Greenwich Hospital, HammondCare, Sydney, New South Wales, Australia.
¹³ Northern Clinical School, Sydney Medical School, HammondCare, Sydney, New South Wales, Australia.
¹⁴ Department of Psychopharmacology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia.
¹⁵ The Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia.
¹⁶ South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.

PMID: 27530738
DOI: 10.1111/imj.13224

Abstract

Background: Australian clinical trials are planned to evaluate medicinal cannabis in a range of clinical contexts.

Aims: To explore the preferences, attitudes and beliefs of patients eligible and willing to consider participation in a clinical trial of medicinal cannabis for poor appetite and appetite-related symptoms from advanced cancer.

Methods: A cross-sectional anonymous survey was administered from July to December 2015 online and in eight adult outpatient palliative care and/or cancer services. Respondents were eligible if they were ≥18 years, had advanced cancer and poor appetite/taste problems/weight loss and might consider participating in a medicinal cannabis trial. Survey items focused on medicinal rather than recreational cannabis use and did not specify botanical or pharmaceutical products. Items asked about previous medicinal cannabis use and preferences for delivery route and invited comments and concerns.

Results: There were 204 survey respondents, of whom 26 (13%) reported prior medicinal cannabis use. Tablets/capsules were the preferred delivery mode (n = 144, 71%), followed by mouth spray (n = 84, 42%) and vaporiser (n = 83, 41%). Explanations for preferences (n = 134) most commonly cited convenience (n = 66; 49%). A total of 82% (n = 168) of respondents indicated that they had no trial-related concerns, but a small number volunteered concerns about adverse effects (n = 14) or wanted more information/advice (n = 8). Six respondents volunteered a belief that cannabis might cure cancer, while two wanted assurance of efficacy before participating in a trial.

Conclusion: Justification of modes other than tablets/capsules and variable understanding about cannabis and trials will need addressing in trial-related information to optimise recruitment and ensure that consent is properly informed.

Keywords: anorexia; attitude; cancer; cannabis; clinical trial.

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Anorexia / drug therapy*
Appetite / drug effects*
Australia
Clinical Trials as Topic
Cross-Sectional Studies
Female
Health Knowledge, Attitudes, Practice*
Humans
Logistic Models
Male
Medical Marijuana / administration & dosage
Medical Marijuana / therapeutic use*
Middle Aged
Neoplasms / complications*
Patient Participation
Patient Preference*
Self Report
Young Adult

Substances

Medical Marijuana