ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 263
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Medicinal cannabis in Australia: Use, access, surveillance
and the detection of ‘signals’ using novel digital monitoring
approaches
Dr Christine Mary Hallinan1, Yvonne Bonomo2
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Department of General Practice, Melbourne Medical School, The University of Melbourne,
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St Vincent’s Hospital, Department of Addiction Medicine, Melbourne
Medicinal cannabis (MC) was legalised in Australia in 2016. This led to the establishment of a pathway
by the Australian Therapeutic Goods Administration (TGA) to enable physicians to prescribe MC to
patients under the TGA Special Access Scheme. Following legalisation, MC prescription approvals
rose exponentially from 33 approvals in the month of February 2017 to 13,622 in September 2021.
Since then, monthly approvals have stabilised at around 10,000 per month. Whilst rates of approvals
have steadied, 10,000 approvals per month still represent a significant volume of prescribing, as
physician applications approved by the TGA often provide prescriptions with ‘repeat scripts’, as well
as patient access to multiple MC products. Some prescriptions can contain up to 10 repeats. From
January 2017 to January 2023, 4798 physicians submitted prescription applications for a cumulative
total of 334,813 approvals, on behalf of at least 50,000 patients.
In our suite of research, we used retrospective TGA data to investigate the number of applications
approved, prescriber type, patient demographic and MC formulation. We undertook multiple reviews,
and we interviewed 21 Australian physicians from a variety of clinical settings to create a narrative on
general practitioner, medical specialist, pharmacist and policy maker responses to the legalisation
of MC. We investigated consumer perspectives, and examined the impact of jurisdictional legislative
disparities, costs and stigma on patient access to MC.
Importantly, we established that there is no robust comprehensive national MC monitoring system
to ascertain effects and detect ‘signals’ that could be attributed to the presence of side effects
and adverse events. Our research has shown it is imperative we use innovative pharmacovigilance
approaches, such as electronic medical record monitoring and social media surveillance, to monitor
MC; we assert the same novel approaches can be used to monitor other unregistered therapeutics as
they emerge in the prescribing landscape, such as psychedelics.
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