Medical Cannabis and Utilization of Nonhospice Palliative Care Services: Complements and Alternatives at End of Life

James A Croker; Julie Bobitt; Kanika Arora; Brian Kaskie

doi:10.1093/geroni/igab048

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Medical Cannabis and Utilization of Nonhospice Palliative Care Services: Complements and Alternatives at End of Life

Journal article

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Peer reviewed

Medical Cannabis and Utilization of Nonhospice Palliative Care Services: Complements and Alternatives at End of Life

James A Croker, Julie Bobitt, Kanika Arora and Brian Kaskie

Innovation in aging, Vol.6(1), pp.1-15

2022

DOI: 10.1093/geroni/igab048

PMCID: PMC8759444

PMID: 35047709

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Abstract

Abstract Background and Objectives There is a need to know more about cannabis use among terminally diagnosed older adults, specifically whether it operates as a complement or alternative to palliative care. The objective is to explore differences among the terminal illness population within the Illinois Medical Cannabis Program (IMCP) by their use of palliative care. Research Design and Methods The study uses primary, cross-sectional survey data from 708 terminally diagnosed patients, residing in Illinois, and enrolled in the IMCP. We compared the sample on palliative care utilization through logistic regression models, examined associations between palliative care and self-reported outcome improvements using ordinary least squares regressions, and explored differences in average pain levels using independent t-tests. Results 115 of 708 terminally diagnosed IMCP participants were receiving palliative care. We find increased odds of palliative care utilization for cancer (odds ratio [OR] [SE] = 2.15 [0.53], p < .01), low psychological well-being (OR [SE] = 1.97 [0.58], p < .05), medical complexity (OR [SE] = 2.05 [0.70], p < .05), and prior military service (OR [SE] = 2.01 [0.68], p < .05). Palliative care utilization is positively associated with improvement ratings for pain (7.52 [3.41], p < .05) and ability to manage health outcomes (8.29 [3.61], p < .01). Concurrent use of cannabis and opioids is associated with higher pain levels at initiation of cannabis dosing (p < .05). Discussion and Implications Our results suggest that cannabis is largely an alternative to palliative care for terminal patients. For those in palliative care, it is a therapeutic complement used at higher levels of pain.

Prescription opioids

Symptom management

Pain management

Self-reported outcomes

Details

Title: Subtitle: Medical Cannabis and Utilization of Nonhospice Palliative Care Services: Complements and Alternatives at End of Life
Creators: James A Croker - Department of Health Management and Policy, University of Iowa, Iowa City, Iowa, USA
Julie Bobitt - Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
Kanika Arora - Department of Health Management and Policy, University of Iowa, Iowa City, Iowa, USA
Brian Kaskie - Department of Health Management and Policy, University of Iowa, Iowa City, Iowa, USA
Resource Type: Journal article
Publication Details: Innovation in aging, Vol.6(1), pp.1-15
DOI: 10.1093/geroni/igab048
PMID: 35047709
PMCID: PMC8759444
NLM abbreviation: Innov Aging
eISSN: 2399-5300
Publisher: Oxford University Press
Grant note: DOI: 10.13039/100004888, name: Illinois Department of Public Health, award: 93107003G
Language: English
Date published: 2022
Academic Unit: Health Management and Policy
Record Identifier: 9984221744302771

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