Barriers to Achieving Optimal Success with Medical Cannabis: Opportunities for Quality Improvement.

This commentary describes the clinician experience of certifying patients for medical cannabis (MC) in a north suburban Chicago integrative family medicine practice. The physician and research assistant performed a comprehensive chart review of the first 166 MC patients certified in the practice. Based on this review, barriers and opportunities were elucidated to improve delivery of MC therapy in Illinois within the existing framework of regulation, licensing, certification, and distribution. The following factors have posed challenges for the Illinois Medical Cannabis Pilot Program. These factors are interrelated and include: (1) inadequate scientific knowledge regarding effectiveness, dosage, delivery mechanism, indications, and drug interactions in humans; (2) lack of educational standards for dispensary and medical staff training; (3) lack of communication and coordination of patient care; (4) complexity and inconsistent availability of dosing options; and (5) barriers to access for patients seeking this therapy.