PICOT /CAPSTONE

Criteria

Article 1

Article 2

Article 3

Article 4

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

Vyas M.B, LeBaron V.T, Gilson A.M.

https://www.ncbi.nlm.nih.gov/pubmed/28993073

J Clin Oncol

https://www.ncbi.nlm.nih.gov/pubmed/29746226

J Clin Oncol

https://www.ncbi.nlm.nih.gov/pubmed/30205775

Zaki,Pearl., Blake,Alexia, Wolt, Amiti, Chan, Stephanie

https://www.researchgate.net/publication/324088950_The_Use_of_medical_cannabis_in_cancer_patients

Article Title and Year Published

The use of cannabis in response to the opioid crisis: A review of the literature. 2018

Medical Oncologists' Beliefs, Practices, and Knowledge Regarding Marijuana Used Therapeutically: A Nationally Representative Survey Study. 2018

Medical Marijuana Use in a Community Cancer Center. 2018

The use of medical cannabis in cancer patients. 2017

Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study

The purpose of the article is to examine state medical cannabis (MC) use laws and policies and their potential association with POM use and related harms.

To determine whether oncologists reported discussing MM with patients, recommended MM clinically in the past year, or felt sufficiently informed to make such recommendations.

Compare the incidence of marijuana use between patients with early- versus advanced-stage cancers. Examine differences in adverse effects, drug-drug interactions, and drug-disease interactions between those who use marijuana and those who do not.

To examine the efficacy of cannabis treatment among cancer patients to manage symptoms from a single Canadian medical cannabis provider

Design (Type of Quantitative, or Type of Qualitative)

Quantitative: Exploratory study

A systematic literature review was conducted to explore United States policies related to MC use and the association with POM use and related harms. Medline, PubMed, CINAHL, and Cochrane databases were searched to identify peer-reviewed articles published between 2010 and 2017

Quantitative Study

Bivariate and multivariate analyses were performed using standard statistical techniques.

Quantitative Study

The overall incidence of marijuana use was 18.3% (32 of 175 patients). The incidence of marijuana uses in patients with early- versus advanced-stage cancers was 19.6% (11 of 56 patients) versus 17.6% (21 of 119 patients; P = .75).

Quantitative Study

164 patients reported a current or previous diagnosis of cancer, of which the most common types

of primary tumors were gastrointestinal (17.7%, n = 29),

breast (13.4%, n = 22), leukemia and lymphoma (13.4%, n = 22), gynecologic (9.2%, n = 15), prostate (7.3%, n = 12), and lung (7.3%, n = 12).

Setting/Sample

A systematic literature review 11,513 records were identified, with 789 abstracts reviewed, and then 134 full-text articles screened for eligibility via Medline, PubMed, CINAHL, and Cochrane databases to identify peer-reviewed articles published between 2010 and 2017.

A survey on random sample of 400 medical oncologists.

Electronic self-reported questionnaire completed by patients age 18 years and older who were receiving chemotherapy.

164 cancer patients

Methods: Intervention/Instruments

A systematic literature review on EBP peer- article to support the use of MM verse opioid use

Randomize survey on oncologist.

Questionnaire

Online survey of 2573 patients, use of Pain Self-Efficacy Questionnaire

Analysis

A systematic literature review was conducted to explore the use of cannabis in response to the opioid crisis:

Analysis of responses of oncologist on the use of MM in pain in patient

Analysis of data indicating the implications of cannabis treatment on cancer patients.

Analysis of data collected from survey from periods of between 4 to 10 months from initial use of cannabis by cancer patients

Key Findings

Of 134 articles, 10 articles met inclusion criteria. The literature suggests MC laws could be associated with decreased POM use, fewer POM-related hospitalizations, lower rates of opioid overdose, and reduced national health care expenditures related to POM overdose and misuse.

Overall response 63%. 30% of oncologists felt sufficiently informed to make recommendations, 80% discussions with patients, 46% recommended for clinical use. 67% viewed it as a helpful adjunct to standard pain management strategies, and 65% thought MM is equally or more effective than standard treatments for anorexia and cachexia

The overall incidence of marijuana use was 18.3% (32 of 175 patients). early- versus advanced-stage cancers was 19.6% (11 of 56 patients) versus 17.6% (21 of 119 patients; P = .75)

164 patients indicated current or prior cancer diagnosis and 56.3 percent previously used cannabis for symptom relief while 73.6 percent reported current use

Recommendations

Review of the current literature suggests states that implement MC policies could reduce POM-associated mortality, improve pain management, and significantly reduce health care costs

More research is needed regarding critical gaps in research, medical education, and policy regarding MM.

The risks versus benefits should be discussed with all patients who use marijuana.

Need for more studies to establish the efficacy of medical cannabis as compared to first line therapies among cancer patients

Explanation of How the Article Supports EBP/Capstone Project

Having knowledge that MM use reduces the number of overdoses seen with other pain management suppose the cause for the use of cannabis in cancer patient for pain relief.

This article provided EBP date that provided oncologist thoughts on the use of MM patient dealing with cancer

This article provided information that was relevant towards my EBP as it relates to drug interactions, benefits and limitation of MM

This article provided information on the outcome of a year along use of cannabis used among cancer patients

Criteria

Article 5

Article 6

Article 7

Article 8

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

Abrams, D.I.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4791148/

Johnson JR; Lossignol D; Burnell-Nugent M; Fallon MT

Jessica. C, Paul. J, D

http://ascopubs.org/doi/10.1200/jco.2015.33.29_suppl.198

Alexia B, Bo A, W, Leila. M, C, DeAngelis, Patrick D, Nicholas L, Edward C, O’Hearn. S

http://apm.amegroups.com/article/view/16199/18209

Article Title and Year Published

Integrating cannabis into clinical cancer care, 2016

An open-label extension study to investigate the long-term safety and tolerability of THC/CBD oro-mucosal spray and oro-mucosal THC spray in patients with terminal cancer-related pain refractory to strong opioid analgesics. 2013

Use of medical cannabis to reduce pain and improve quality of life in cancer patients. 2017

A selective review of medical cannabis in cancer pain management. 2017

Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study

The purpose of the article is show Integrating cannabis into clinical cancer care

The purpose of the study was investigated the long-term safety and tolerability of THC/CBD spray and THC spray in relieving pain in patients with advanced cancer.

The purpose of the study is to determine if the addition of cannabinoids (medical cannabis) resulted in the reduction of the average opioid dose required for pain control and improve self-reported quality of life indices.

To evaluate the efficacy of cannabinoid-based therapies containing tetrahydrocannabinol (THC) and cannabidiol (CBD) for reducing cancer-associated pain

Design (Type of Quantitative, or Type of Qualitative)

Qualitative study

Exploratory study

Quantitative Study

A review of literature: Quantitative Study

A variety of doses ranging from 2.7–43.2 mg/day THC and 0–40 mg/day CBD were administered. Higher doses of THC were correlated with increased pain relief in some studies. One study found that significant pain relief was achieved in doses as low as 2.7–10.8 mg THC in combination with 2.5–10.0 mg CBD, but there was conflicting evidence on whether higher doses provide superior pain relief.

Setting/Sample

28 studies of 2454 participants

43 patients with cancer-related pain

(n = 24). Patient 18 and older

Five studies that evaluated THC oil capsules, THC: CBD oromucosal spray (nabiximols), or THC oromucosal sprays found some evidence of cancer pain reduction associated with these therapies.

Methods: Intervention/Instruments

Study of randomized clinical trials of participants

Randomized controlled trial of 43 patients

A retrospective chart review of cancer patients followed in our CCMB Pain and Symptom Clinic was conducted.

Small pilot studies conducted in 1975, to double-blind placebo-controlled trials conducted in 2014

Analysis

Analysis of data indicating the implications of cannabis treatment on cancer patients in several clinical trials

Analysis of data available to support use of cannabis for cancer treatment

Review of cancer patients followed in our CCMB Pain and Symptom Clinic was conducted

Reviews the history of marijuana for relief and therapy treatment of cancer patients

Key Findings

Cannabis has certain benefits particularly handling symptoms, and direct anticancer effects of cannabinoids

No new safety concerns associated with the extended use of THC/CBD spray arose from this study. This study showed that the long-term use of THC/CBD spray was generally well tolerated, with no evidence of a loss of effect for the relief of cancer-related pain with long-term use

Patients with cancer pain benefited from the addition of cannabinoids

Significant pain relief was achieved in doses as low as 2.7–10.8 mg THC in combination with 2.5–10.0 mg CBD, but there was conflicting evidence on whether higher doses provide superior pain relief

Recommendations

Need for more human studies to manage current effects

The outcome of the study was met.

Further prospective controlled studies are needed to further elucidate the role of cannabinoids in the treatment of cancer pain.

There is a need for the conduct of further double-blind, placebo-controlled clinical trials with large sample sizes to establish the optimal dosage and efficacy of different cannabis-based therapies.

Explanation of How the Article Supports EBP/Capstone

Discusses studies available indicating outcome of use of cannabis in cancer management that can be used to support my capstone project.

Provides expert opinion on use of medical marijuana in cancer management

This article provided EBP data on the outcome for patient who used MM for pain treatment

The article provided studies available indicating outcome of use of cannabis in cancer management in 1975 and 2014. Give an insight as to how long MM has been studied