Abstracts

Rationale:
Evidence for medicinal cannabis in epilepsy has emerged in recent years. Clinical trials supports the use of cannabidiol (CBD) in two rare childhood epilepsy syndromes. Patient perception of the evidence base, indication, therapeutic efficacy and side-effect profile of medicinal cannabis often lags behind medical professionals. This has implications for patients as they often source these products privately at significant personal cost. We aimed to assess patient perception  of medicinal cannabis and compare with the current evidence. We also aimed to evaluate the sources patients use when informing themselves about medicinal cannabis.
Method:
We acquired a random sample of 50 patients who attend the  epilepsy clinic in Beaumont Hospital, Dublin, Ireland. Data regarding diagnosis, seizure control and current anti-epileptic medications were acquired via the electronic patient record. We contacted the patients via telephone and consented them for participation in the survey. A short questionnaire which included questions on sources of information on medicinal cannabis, openness to trialling medicinal cannabis products, and knowledge regarding the indications and side-effect profile of medicinal cannabis. In the case of patients with intellectual disability, the survey was completed by the next of kin. Results50 patients were contacted with a participation rate of 72%. This patient population comprised of patients with focal epilepsy (58%), idiopathic generalised epilepsy (22%) and epilepsy with developmental encephalopathy (8%). Thirty-three percent of patients had medication refractory epilepsy.  Sixty-six percent of patients had heard of medicinal cannabis use in epilepsy. The most common source of information included online & social media (28%), audiovisual & print media (25%) and word of mouth (8%). Twenty-five percent were aware of current medical indications for medicinal cannabis. Sixty-eight percent of patients would be willing to trial medicinal cannabis for epilepsy. For the majority of patients (82%), the opinion of their doctor was classified as ‘very important’ before trialling medicinal cannabis. Thirty-seven percent perceived medicinal cannabis as safer than conventional AEDs and 43% classified it as a ‘herbal supplement’, rather than a medicinal product.  Twenty-one percent were aware of side effects associated with medicinal cannabis. Only fifteen percent had ever used recreational cannabis.
Conclusion:
Patient perceptions of medicinal cannabis in epilepsy are discordant with that of epilepsy professionals, and are influenced by social and audiovisual media.  Improvement in patient education around medicinal cannabis use in epilepsy is needed and should be part of any epilepsy program.
Funding:
:n/a