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Knowledge and attitudes of Italian medical oncologists and palliative care physicians toward medical use of cannabis in cancer care: a national survey

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Abstract

Purpose

Despite advances in supportive care, cancer-related symptoms tend to be persistent regardless of cancer type, stage of disease, or treatment received. There is an increasing prescription for complementary and alternative medicines, such as medical cannabis (MC). Knowledge and attitudes of Italian medical oncologists and palliative care physicians toward medical cannabis in cancer care remain unknown.

Methods

We conducted a cross-sectional study to investigate the knowledge and attitude toward MC prescription among cancer care professionals in Italy. All invited participants received an email with the electronic questionnaire accessible through a direct link.

Results

Among the 2616 members who received the invitation, 475 replied to the questionnaire and were considered for the survey analysis. The most prescribed formulations among those available in Italy were cannabis FM2. The most frequent clinical indications for the use of MC were pain, gastrointestinal, and mood disorders. Only 9 responders reported MC-related side effects like anxiety insomnia and muscle spasms. The question regarding the normative references for MC prescription and use in Italy had conflicting results: only 14% indicated the exact legislative reference.

Conclusion

Our study highlights a significant discrepancy between personal attitudes, prescription levels, and actual knowledge on MC. This represent a critical issue that should be systemically faced, building educational programs and national guidelines that sublimate personal physicians’ beliefs and predispositions, resulting in a robust science-based MC practice. Only through coordinated interventions on science and health policy of MC, there will be success of safety and efficacy, ensuring the best knowledge for the best outcomes.

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Data availability

All databases will be sent if requested.

Code availability

None.

Change history

  • 23 July 2021

    Updated due to the incorrect tagging of name in the xml for David James Pinato.

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Acknowledgements

The Authors wish to thank AIOM (Associazione Italiana di Oncologia Medica) and SICP (Società Italiana di Cure Palliative) for sharing this survey among all members of the societies. The authors are particularly grateful to all the survey participants who made this study possible. DJP acknowledges infrastructural support by the Cancer Research UK Imperial Centre and the Imperial NIHR Biomedical Research Centre.

Funding

DJP received support from the Wellcome Trust Strategic Fund (PS3416 to DJP).

Author information

Authors and Affiliations

  1. Medical Oncology Unit, Sapienza University of Rome, Via di Grottarossa, 1035-1039, Rome, Italy

    Marco Filetti & Paolo Marchetti

  2. Division of Early Drug Development for Innovative Therapies, European Institute of Oncology IRCCS, Milan, Italy

    Dario Trapani

  3. Department of Biotechnology and Applied Clinical Science, University of L’Aquila, L’Aquila, Italy

    Alessio Cortellini & Giampiero Porzio

  4. Department of Surgery and Cancer, Imperial College London, London, UK

    Alessio Cortellini & David James Pinato

  5. Department of Clinical Medicine Life Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy

    Vincenza Cofini & Stefano Necozione

  6. Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy

    David James Pinato

  7. Department of Clinical and Molecular Medicine, Sapienza University of Rome, Roma, Lazio, Italy

    Paolo Marchetti

  8. Medical Oncology Unit, Azienda Ospedaliero Universitaria Sant’Andrea, Via di Grottarossa, 1035-39 00189, Rome, Italy

    Raffaele Giusti

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  1. Marco Filetti
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  2. Dario Trapani
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  3. Alessio Cortellini
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  4. Vincenza Cofini
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  6. David James Pinato
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  9. Raffaele Giusti
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Contributions

Conceived and designed the survey: Raffaele Giusti; collected the data: Raffaele Giusti; contributed data or analysis tools: Raffaele Giusti, Alessio Cortellini, Vincenza Cofini, and Stefano Necozione; performed the analysis: Raffaele Giusti; wrote the paper: Marco Filetti, Dario Trapani, Alessio Cortellini, David J Pinato, and Raffaele Giusti; other contribution: Marco Filetti, David J Pinato, Giampiero Porzio, Paolo Marchetti, and Raffaele Giusti; and final approval: Marco Filetti, Dario Trapani, Alessio Cortellini, Vincenza Cofini, Stefano Necozione, David J Pinato, Giampiero Porzio, Paolo Marchetti, and Raffaele Giusti.

Corresponding author

Correspondence to Raffaele Giusti.

Ethics declarations

Ethics approval

The survey did not provide any intervention to research participants. Official approval was obtained from AIOM (Associazione Italiana di Oncologia Medica) and SICP (Società Italiana di Cure Palliative) scientific committees to share the survey questionnaire through their mailing lists.

Consent to participate

All participants gave their consents before completing the questionnaire.

Competing interests

MF, DT, VC, SN, GP, and PM declare no competing interests. AC declare consulting/advisory board fees from Astrazeneca, MSD, Roche and BMS; speakers’ fee from Novartis, Astellas, MSD, Astrazeneca. DJP received lecture fees from ViiV Healthcare and Bayer Healthcare and travel expenses from BMS and Bayer Healthcare; consulting fees for Mina Therapeutics, EISAI, Roche, and Astrazeneca; and received research funding (to institution) from MSD and BMS. RG received speaker fees and grant consultancies from Astrazeneca, Boehringer Ingelheim, Roche, and Takeda.

*Chi-square test or Fisher’s exact test.

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Filetti, M., Trapani, D., Cortellini, A. et al. Knowledge and attitudes of Italian medical oncologists and palliative care physicians toward medical use of cannabis in cancer care: a national survey. Support Care Cancer 29, 7845–7854 (2021). https://doi.org/10.1007/s00520-021-06383-7

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  • DOI: https://doi.org/10.1007/s00520-021-06383-7

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