Langley Paul C
College of Pharmacy, University of Minnesota.
Innov Pharm. 2019 Aug 31;10(2). doi: 10.24926/iip.v10i2.1800. eCollection 2019.
In a previous commentary in INNOVATIONS in pharmacy, the question was raised as to the questions legislators should ask for the licensing of medical marijuana dispensaries. The case was made that if dispensaries accept they have a duty of care then they should be required to monitor patients over the course of their treatment with botanical cannabis, including hemp based product, to evaluate the response of patients to therapy. One option would be for individual dispensaries (or owners of multiple licenses and dispensary locations) to adopt a registry format and implement an on-line reporting system by registry staff and patients for the conditions being treated. Unfortunately, under present legislative rules for dispensaries there is no incentive for dispensaries to make the necessary investment. It is also unlikely that legislators would be prepared to mandate a registry requirement. The purpose of this commentary is to offer an alternative solution. Rather than dispensary specific registries, a state-wide low cost registry is proposed where dispensaries are required to log in and track patients with specific conditions. In the case of severe pain, a dispensary would log in patients presenting with this condition and the patient tracked over their course of treatment. A further advantage with a statewide registry is that if a patient visits a different dispensary they can still be tracked as they would be identified by their marijuana card number. The ability to track patients by condition, while still resident in a state, would not only minimize the issue of incomplete records, but would provide a comprehensive, research quality framework for evaluating claims for botanical cannabis. This could then provide feedback to legislators and establish a robust basis for rule making.
在之前发表于《药学创新》的一篇评论文章中，有人提出了立法者在发放医用大麻药房许可证时应提出哪些问题。文中指出，如果药房承认它们有注意义务，那么就应该要求它们在患者使用植物性大麻（包括基于大麻的产品）进行治疗的过程中对患者进行监测，以评估患者对治疗的反应。一种选择是各个药房（或拥有多个许可证和多个药房地点的所有者）采用登记册形式，并由登记册工作人员和患者实施一个在线报告系统，用于记录正在治疗的病症。不幸的是，根据目前针对药房的立法规定，药房没有动力进行必要的投资。而且立法者也不太可能准备好强制要求建立登记制度。本评论文章的目的是提供一种替代解决方案。提议建立一个全州范围的低成本登记册，而不是特定于药房的登记册，要求药房登录并跟踪患有特定病症的患者。以严重疼痛为例，药房将登录患有这种病症的患者信息，并在其治疗过程中跟踪该患者。全州范围登记册的另一个优点是，如果患者前往不同的药房就诊，他们仍然可以被跟踪，因为他们可以通过大麻卡号码被识别出来。在患者仍居住在该州的情况下，按病症跟踪患者的能力不仅可以将记录不完整的问题最小化，还将为评估植物性大麻的疗效提供一个全面的、具有研究质量的框架。这进而可以为立法者提供反馈，并为制定规则奠定坚实基础。
