Vaillancourt Régis, Moreno Maria, Pouliot Annie, Sell Erick
, OMM, CD, BPharm, PharmD, FCSHP, is with the Department of Pharmacy, Children's Hospital of Eastern Ontario, Ottawa, Ontario, PharmD, is with the Leslie Dan School of Pharmacy, University of Toronto, Toronto, Ontario, PhD, was, at the time this study was conducted, with the Department of Pharmacy, Children's Hospital of Eastern Ontario, Ottawa, Ontario, MD, is with the Faculty of Medicine, University of Ottawa, Ottawa, Ontario.
Can J Hosp Pharm. 2020 Mar-Apr;73(2):105-115. Epub 2020 Apr 1.
The study of the use of cannabis for therapeutic purposes in the pediatric population is increasing, yet data on efficacy and safety are limited. Characterization of pediatric cannabis use for therapeutic purposes will improve understanding of the circumstances under which it occurs and the associated outcomes.
To describe the use of cannabis for therapeutic purposes, regardless of authorization, in a pediatric tertiary teaching hospital.
A retrospective chart review was completed for patients 18 years of age or younger who used cannabis for therapeutic purposes, regardless of authorization, between May 1, 2014, and May 1, 2017. Patients whose cannabis use was documented as recreational were excluded.
In total, 300 patients were identified, of whom 37 met the inclusion criteria. Of these, 30 patients had documentation of medically supervised cannabis use. Most were using cannabis for seizures ( = 28), and many of these ( = 23) were patients with seizures described as intractable or refractory. Of the 27 patients who were experiencing seizures at initiation of medical cannabis, 21 had documentation of a decrease in seizure frequency. This decrease was transient for 16 patients, with a mean duration of 130.4 days (standard deviation 99.1 days). Seven patients self-medicated with cannabis. They obtained cannabis without authorization and used it for chronic pain ( = 5) and/or anxiety ( = 5).
Medically supervised cannabis use occurred most often in patients with intractable or refractory seizures. According to these data, seizure response is variable, and initial decreases may be transient for pediatric patients using cannabis. To ensure greater consistency and rigour in the conduct of prospective research and thus to generate better-quality research on the therapeutic effects of medical cannabis, development of a standardized care record is needed.
儿科人群中使用大麻进行治疗的研究日益增多，但关于疗效和安全性的数据有限。对儿科治疗性大麻使用情况的描述将有助于更好地理解其发生的背景及相关结果。
描述一家儿科三级教学医院中无论是否获得授权的治疗性大麻使用情况。
对2014年5月1日至2017年5月1日期间18岁及以下使用大麻进行治疗（无论是否获得授权）的患者进行回顾性病历审查。将大麻使用记录为娱乐性使用的患者排除。
共识别出300名患者，其中37名符合纳入标准。其中，30名患者有医学监督下大麻使用的记录。大多数患者使用大麻治疗癫痫（n = 28），其中许多（n = 23）是被描述为难治性或顽固性癫痫的患者。在开始使用医用大麻时正在经历癫痫发作的27名患者中，21名有癫痫发作频率降低的记录。16名患者的这种降低是短暂的，平均持续时间为130.4天（标准差99.1天）。7名患者自行使用大麻。他们未经授权获取大麻并将其用于慢性疼痛（n = 5）和/或焦虑（n = 5）。
医学监督下的大麻使用最常发生在难治性或顽固性癫痫患者中。根据这些数据，癫痫反应是可变的，使用大麻的儿科患者最初的发作频率降低可能是短暂的。为确保前瞻性研究的实施更加一致和严谨，从而产生关于医用大麻治疗效果的更高质量研究，需要制定标准化的护理记录。
