Less than 11% of Canadian nephrologists prescribe cannabis for CKD management

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A small percentage of Canadian nephrologists reported prescribing cannabis for chronic kidney disease management, according to data published in Kidney Medicine.

Further, nephrologists reported that the legalization of medical cannabis in 2018 did not have a great impact on their practice or prescriptions.

“Given the paucity of evidence regarding the safety or efficacy of cannabis in CKD, understanding current attitudes and practicing patterns of nephrologists is critical,” Kevin Gitau, MD, from the division of general internal medicine at St. Michael’s Hospital of Unity Health Toronto at the University of Toronto in Canada, and colleagues wrote.

“Therefore, the objective of our study is to survey nephrologists working across Canada about their current prescribing habits, attitudes and overall comfort level with the use of cannabis products among individuals with CKD in the context of recent change in legal status.”

In April 2020, researchers sent a nationwide mail-in survey to every registered nephrologist in Canada (n=723) and accepted responses until October. The survey consisted of two phases. Although excluded from the final analyses, the first phase asked a small group of nephrologists to complete the survey and provide feedback on confusing questions.

According to the study, the second phase of the survey asked nephrologists about their demographics, experience with cannabis-use, current cannabis prescribing practices, attitudes toward use of cannabis for symptom management in CKD, overall safety and therapeutic concerns about the use of cannabis, knowledge of active pharmaceutical components in cannabis and differences in preference for different formulations and awareness regarding cannabis use patterns among patients in the clinician’s practice.

The survey package included the survey, a consent form with instructions for survey completion and a $5 gift card.

Among the 723 nephrologists invited to participate in the survey, 208 responded. Of the responding individuals, 10.1% currently prescribe cannabis, and they reported prescribing it for chronic pain management 95.2% of the time. More than half of the participants claimed the new legality of cannabis in Canada did not affect their decision to prescribe it, and 59% reported they were uncomfortable about their understanding of medical cannabis literature.

“Given the potential benefits of cannabis relative to other current symptom management strategies, the kidney care community should embrace this untapped therapeutic area via further prospective evaluation of cannabis in patients with CKD,” Gitau and colleagues wrote.

“If proven efficacious, there is great potential for improving symptom management in a population with a high symptom burden and significant impairments in quality of life.”

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