One of the key contributing factors to increasing access to cannabis medicines in the UK is engaging and educating doctors, writes Alex Fraser, patient access lead at GROW Pharma.
At the time of writing, there are 60-70 doctors regularly prescribing unlicensed cannabis medicines in the UK and Channel Islands. In this piece, we discuss hurdles to becoming a prescriber and how GROW Pharma is facing this head-on in successfully bringing new doctors into the world of medical cannabis.
One issue is that the legislation currently restricts GPs from prescribing. Traditionally it is a patient’s GP who recommends new treatments and refers to specialist doctors, but with no remit to prescribe or incentive to learn about medical cannabis, referrals from GP’s are uncommon. Fortunately, patients can self-refer, but this relies on the patient already being aware of cannabis medicines and the clinics they might contact to enquire about a prescription. Last year we set up www.opencannabis.uk as a hub of information for patients and healthcare professionals for exactly this reason. There is a lack of general awareness about the availability and cost of prescribed medical cannabis, and we are working hard to change that.
There’s no sign the regulations that prevent GPs from prescribing will be changed anytime soon, but that’s no reason we should not engage with GPs. GROW Pharma invites all doctors to contact us to learn about medical cannabis and how to provide the best route of access to these medicines for their patients if they cannot prescribe themselves. We’re also aware that many doctors may be sceptical about cannabis medicines, so we’ve provided useful tools such as CALYX, our patient app, which gives patients the option to record and track their progress on cannabis medicines and feed this back to their doctor, be they a sceptical GP or specialist, or simply interested in the impact these medicines are having on their patients. Patients too can make a difference. Many will have multiple doctors they speak to regularly who may not be aware that they can prescribe, or refer patients to prescribers of cannabis medicines.
There is also a distinct lack of guidance from authoritative medical bodies such as NICE, with others, such as the BPNA, actively warning against the prescribing of cannabis medicines within their area of specialism, quoting the need for more research as the main reason for this. They have correctly identified the absence of large-scale RCTs but that doesn’t take away from the massive body of evidence around safety and the positive impact on the quality of life these medicines can have. It is important to remember that cannabis medicines do not treat illnesses, they help patients manage their symptoms.
The BMJ recently published guidance on the use of non-inhaled cannabis medicines for certain types of pain, which is great to see. More should and could be done to highlight where these medicines might be prescribed to best help patients manage symptoms, particularly in unmanaged chronic pain and certain psychiatric disorders
Lack of awareness is also a key factor. Cannabis has a reputation problem, associated with illicit or recreational markets but not necessarily known as a plant that produces compounds with significant medical potential. This is changing through the experiences that individual prescribers have with patients, yet many healthcare professionals are still not aware of cannabis use as a medicine and the private prescription route for access.
This is why GROW Pharma has launched a series of educational webinars for healthcare professionals on prescribing cannabis medicines in practice. Utilising the expert knowledge from prescribers in other countries, such as Canada, where doctors have many years of prescribing experience under their belts, as well as the scientific know-how from the top educators working with globally renowned producers of cannabis medicines such as CSO of Columbia Care Rosemary Mazanet and Director of Medical Affairs at Tilray Jose Tempero (who have both presented in our first “round” of webinars), we have been successful in supporting new doctors to start prescribing.
If you missed out on these webinars, do not fear!
More are coming this month on the 4th and 22nd of November (both with Rosemary Mazanet MD) and all previous webinars are recorded and hosted on our Dr Portal so that Doctors can watch and learn in their own time. As well as their work supporting current prescribers day-to-day, our MSL team are present on these webinars to answer questions and, where appropriate, provide links to relevant research.
Royal Society of medicine and GROW
Doctors who do decide to prescribe cannabis medicines often join pre-existing “cannabis clinics” that specialise in prescribing cannabis medicines and act as hubs of expertise in which doctors can learn about cannabis medicines from their peers. Integro Medical Clinics are one such clinic that we work closely with. Integro assists in doctor education by inviting them to join their MDT meetings to see for themselves how prescribing decisions are made. They also recently hosted a ground-breaking live educational event at the Royal Society of Medicine that GROW were proud to sponsor and participate in. Initiatives like these massively help with introducing more doctors to medical cannabis.
There are several other options for doctors who are new to medical cannabis. GROW can help them in setting up their own clinic or a medical cannabis service within a pre-existing clinic (as we have with Nottingham Road Clinic, who are soon to launch their own medical cannabis service). Doctors can of course prescribe within their own practice or simply refer patients to other doctors in the instance that they don’t wish to set up in prescribing cannabis medicines themselves.
GROW Pharma guide
With all the above GROW Pharma is on hand to guide and support doctors every step of the way, from their first educational webinar to being ready and starting to prescribe. We are on hand to ensure doctors are aware of the latest clinical and pharmacological information on cannabis medicines. We provide practical support in prescribing and a sterling pharmacy service through our partner IPS Pharma, who pride themself on reliability and quality patient service.
Doctors can get in touch with us via our website or sign-up to our Dr Portal to find out about upcoming webinars, educational events and to watch recordings of previous webinars.
They can also access information about the medicines we stock and private forums designed specifically for doctors to discuss cannabis medicines with each other privately.
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