Barriers in accessing medical cannabis for children with drug-resistant epilepsy in Canada: A qualitative study

Epilepsy Behav. 2020 Oct;111:107120. doi: 10.1016/j.yebeh.2020.107120. Epub 2020 Jun 20.

Abstract

Introduction: The use of medical cannabis to treat drug-resistant epilepsy in children is increasing; however, there has been limited study of the experiences of parents with the current system of accessing medical cannabis for their children.

Methods: In this qualitative study, we used a patient-centered access to care framework to explore the barriers faced by parents of children with drug-resistant epilepsy when trying to access medical cannabis in Canada. We conducted semistructured interviews with 19 parents to elicit their experiences with medical cannabis. We analyzed the data according to five dimensions of access, namely approachability, acceptability, availability, affordability, and appropriateness.

Results: Parents sought medical cannabis as a treatment because of a perceived unmet need stemming from the failure of antiepileptic drugs to control their children's seizures. Medical cannabis was viewed as an acceptable treatment, especially compared with adding additional antiepileptic drugs. After learning about medical cannabis from the media, friends and family, or other parents, participants sought authorization for medical use. However, most encountered resistance from their child's neurologist to discuss and/or authorize medical cannabis, and many parents experienced difficulty in obtaining authorization from a member of the child's existing care team, leading them to seek authorization from a cannabis clinic. Participants described spending up to $2000 per month on medical cannabis, and most were frustrated that it was not eligible for reimbursement through public or private insurance programs.

Conclusions: Parents pursue medical cannabis as a treatment for their children's drug-resistant epilepsy because of a perceived unmet need. However, parents encounter barriers in accessing medical cannabis in Canada, and strategies are needed to ensure that children using medical cannabis receive proper care from healthcare professionals with training in epilepsy care, antiepileptic drugs, and medical cannabis.

Keywords: Authorization; Cost; Insurance; Medical cannabis; Pediatric drug-resistant epilepsy.

MeSH terms

  • Adolescent
  • Adult
  • Ambulatory Care Facilities / standards
  • Anticonvulsants / economics
  • Anticonvulsants / therapeutic use
  • Canada / epidemiology
  • Child
  • Child, Preschool
  • Drug Resistant Epilepsy / drug therapy*
  • Drug Resistant Epilepsy / economics
  • Drug Resistant Epilepsy / epidemiology
  • Female
  • Health Services Accessibility / economics
  • Health Services Accessibility / standards*
  • Humans
  • Insurance, Health, Reimbursement / economics
  • Insurance, Health, Reimbursement / standards
  • Male
  • Medical Marijuana / economics
  • Medical Marijuana / therapeutic use*
  • Middle Aged
  • Parents*
  • Qualitative Research*

Substances

  • Anticonvulsants
  • Medical Marijuana