TY - JOUR
T1 - Cannabis and End-of-Life Care
T2 - A Snapshot of Hospice Planning and Experiences Among Illinois Medical Cannabis Patients With A Terminal Diagnosis
AU - Croker, James Alton
AU - Bobitt, Julie
AU - Sanders, Sara
AU - Arora, Kanika
AU - Mueller, Keith
AU - Kaskie, Brian
N1 - Publisher Copyright:
© The Author(s) 2021.
PY - 2022/3
Y1 - 2022/3
N2 - Introduction: Between 2013 and 2019, Illinois limited cannabis access to certified patients enrolled in the Illinois Medical Cannabis Program (IMCP). In 2016, the state instituted a fast-track pathway for terminal patients. The benefits of medicinal cannabis (MC) have clear implications for patients near end-of-life (EOL). However, little is known about how terminal patients engage medical cannabis relative to supportive care. Methods: Anonymous cross-sectional survey data were collected from 342 terminal patients who were already enrolled in (n = 19) or planning to enroll (n = 323) in hospice for EOL care. Logistic regression models compare patients in the sample on hospice planning vs. hospice enrollment, use of palliative care vs. hospice care, and use standard care vs non-hospice palliative care. Results: In our sample, cancer patients (OR = 0.21 (0.11), p <.01), and those who used the fast-track application into the IMCP (OR = 0.11 (0.06), p <.001) were less likely to be enrolled in hospice. Compared to patients in palliative care, hospice patients were less likely to report cancer as their qualifying condition (OR = 0.16 (0.11), p <.01), or entered the IMCP via the fast-track (OR = 0.23 (0.15), p <.05). Discussion: Given low hospice enrollment in a fairly large EOL sample, cannabis use may operate as an alternative to supportive forms of care like hospice and palliation. Clinicians should initiate conversations about cannabis use with their patients while also engaging EOL Care planning discussions as an essential part of the general care plan.
AB - Introduction: Between 2013 and 2019, Illinois limited cannabis access to certified patients enrolled in the Illinois Medical Cannabis Program (IMCP). In 2016, the state instituted a fast-track pathway for terminal patients. The benefits of medicinal cannabis (MC) have clear implications for patients near end-of-life (EOL). However, little is known about how terminal patients engage medical cannabis relative to supportive care. Methods: Anonymous cross-sectional survey data were collected from 342 terminal patients who were already enrolled in (n = 19) or planning to enroll (n = 323) in hospice for EOL care. Logistic regression models compare patients in the sample on hospice planning vs. hospice enrollment, use of palliative care vs. hospice care, and use standard care vs non-hospice palliative care. Results: In our sample, cancer patients (OR = 0.21 (0.11), p <.01), and those who used the fast-track application into the IMCP (OR = 0.11 (0.06), p <.001) were less likely to be enrolled in hospice. Compared to patients in palliative care, hospice patients were less likely to report cancer as their qualifying condition (OR = 0.16 (0.11), p <.01), or entered the IMCP via the fast-track (OR = 0.23 (0.15), p <.05). Discussion: Given low hospice enrollment in a fairly large EOL sample, cannabis use may operate as an alternative to supportive forms of care like hospice and palliation. Clinicians should initiate conversations about cannabis use with their patients while also engaging EOL Care planning discussions as an essential part of the general care plan.
KW - end-of-life
KW - hospice
KW - medical cannabis
KW - palliative care
KW - symptom management
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U2 - 10.1177/10499091211018655
DO - 10.1177/10499091211018655
M3 - Article
C2 - 34002633
AN - SCOPUS:85105979799
SN - 1049-9091
VL - 39
SP - 345
EP - 352
JO - American Journal of Hospice and Palliative Medicine
JF - American Journal of Hospice and Palliative Medicine
IS - 3
ER -