Drug-Related Problems in Palliative Care Patients taking Medical Cannabis at Patient’s Home

Abstract

Background: There has been no published study conducted to assess drug-related problems (DRPs) of medical cannabis use among patients in palliative care during home visits in Thailand.

Objective: To study the number, type, severity, and causes of DRPs, in addition to the planned interventions, intervention acceptance, and intervention outcomes in palliative care patients taking medical cannabis at their homes.

Methods: A retrospective descriptive study using a home care record was conducted during October 2019 and July 2021. DRPs were categorized based on the Pharmaceutical Care Network Europe (PCNE) V.8.02. Severity of DRPs was classified according to the NCC MERP index. All data were analysed using descriptive statistics.

Results: There were 12 patients recruited into this study with a mean age of 60.0 ± 11.1 years. Of these, 11 patients (91.7%) used the extracted THC, and one patient (8.3%) used Tamlaiprasumen. The average home visit was 1.8±0.4 times/patient. There were 24 DRPs within 10 patients (83.3%) detected with DRPs and the most frequent type of DRP was adverse effects of cannabis (70.8%). The severity of DRPs was categorized at level D (83.3%) with the majority cause from patients (44.0%). The intervention of DRPs was at the prescriber level (36.4%) and were accepted among healthcare professionals, patients, and caregivers, which were found in 23 times (95.8%). Most DRPs were successfully solved, which were found 15 times (62.5%).

Conclusion: There is a high proportion of DRPs with medical cannabis use detected among palliative care patients during home visits. The interventions from pharmacists for medical cannabis use are accepted and can solve a large number of DRPs.