Hostname: page-component-669899f699-swprf Total loading time: 0 Render date: 2025-04-26T11:04:16.208Z Has data issue: false hasContentIssue false
  • English
  • Français

Patterns of Nabilone Prescriptions in Canadian Long-Term Care Facilities

Published online by Cambridge University Press:  27 December 2024

Emily M. Winters ,
Jennifer L. Gordon  and
Thomas Hadjistavropoulos Open the ORCID record for Thomas Hadjistavropoulos [Opens in a new window]
Emily M. Winters
Affiliation:
Department of Psychology and Centre on Aging and Health, University of Regina, Regina, SK, Canada
Jennifer L. Gordon
Affiliation:
Department of Psychology and Centre on Aging and Health, University of Regina, Regina, SK, Canada
Thomas Hadjistavropoulos*
Affiliation:
Department of Psychology and Centre on Aging and Health, University of Regina, Regina, SK, Canada
*
Corresponding author: La correspondance et les demandes de tirésàpart doivent être adressées à: / Correspondence and requests for offprints should be sent to: Thomas Hadjistavropoulos, Department of Psychology, University of Regina, Regina, SK, Canada. 3737 Wascana Parkway, Regina, SK, Canada (thomas.hadjistavropoulos@uregina.ca).
Get access Rights & Permissions [Opens in a new window]

Abstract

The purpose of the current study was to understand the prevalence and patterns of cannabinoid use among LTC residents across Canada. We gathered data on cannabinoid prescriptions among LTC residents for one year before and after recreational cannabis legalization. Multi-level modelling was used to examine the effects of demographic and diagnostic characteristics on rates of cannabinoid prescription over time. All prescriptions were for nabilone. There was a significant increase in the proportion of residents prescribed nabilone following the legalization of recreational cannabis in Canada. Residents with relatively more severe pain (based on the Minimum Data Set pain scale), a diagnosis of depression, or a diagnosis of an anxiety disorder were more likely to have received a nabilone prescription. Our results provide valuable information regarding the increasing use of synthetic cannabinoids in LTC. The implications for clinical practice and policy decision-makers are discussed.

Résumé

Résumé

Cette étude avait pour but de cerner la prévalence et les tendances de l’usage de cannabinoïdes parmi les résidents de centres d’hébergement et de soins de longue durée (CHSLD) au Canada. Nous avons recueilli des données sur les ordonnances de cannabinoïdes parmi ces résidents pendant un an avant et un an après la légalisation du cannabis récréatif. La modélisation multiniveau a été utilisée pour examiner l’incidence dans le temps de caractéristiques démographiques et diagnostiques sur les taux de prescription de cannabinoïdes. Toutes les ordonnances prescrivaient du nabilone. Nous avons constaté une augmentation significative de la proportion de résidents à qui du nabilone avait été prescrit à la suite de la légalisation du cannabis récréatif au Canada. Les ordonnances de nabilone étaient plus courantes parmi les résidents souffrant de douleur relativement plus sévère (mesurée d’après une échelle de la douleur fondée sur un ensemble minimal de données) et ayant reçu un diagnostic de dépression ou de trouble de l’anxiété. Nos résultats révèlent de précieux renseignements sur l’usage croissant des cannabinoïdes synthétiques dans les CHSLD. Les conséquences de cette tendance pour la pratique clinique et la prise de décisions politiques y sont analysées.

Keywords

cannabinoidlong-term caredepressionanxietypaindementiacannabinoïdesoins de longue duréedépressionanxiétédouleurdémence
Type
Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , First View , pp. 1 - 8
Check for updates
Copyright
© Canadian Association on Gerontology 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Allan, G. M., Ramji, J., Perry, D., Ton, J., Beahm, N. P., Crisp, N., Dockrill, B., Dubin, R. E., Findlay, T., Kirkwood, J., Fleming, M., Makus, K., Zhu, X., Korownyk, C., Kolber, M. R., McCormack, J., Nickel, S., Noël, G., & Lindblad, A. J. (2018). Simplified guideline for prescribing medical cannabinoids in primary care. Canadian Family Physician, 64(2), 111–120.Google ScholarPubMed
Armstrong, H., Daly, T. J., & Choiniere, J. A. (2016). Policies and practices: The case of RAI-MDS in Canadian long-term care homes. Journal of Canadian Studies, 50(2), 348–367. https://doi.org/10.3138/jcs.50.2.348CrossRefGoogle Scholar
Bahji, A., Breward, N., Duff, W., Absher, N., Patten, S. B., Alcorn, J., & Mousseau, D. D. (2022). Cannabinoids in the management of behavioral, psychological, and motor symptoms of neurocognitive disorders: A mixed studies systematic review. Journal of Cannabis Research, 4(1), 11. https://doi.org/10.1186/s42238-022-00119-yCrossRefGoogle ScholarPubMed
Ballard, C., Waite, J., & Birks, J. (2012). Atypical antipsychotics for aggression and psychosis in Alzheimer’s disease. Cochrane Database System Review, 1. https://doi.org/10.1002/14651858.CD003476.pub2.www.cochranelibrary.comGoogle Scholar
Baumbusch, J., & Sloan Yip, I. (2021). Exploring new use of cannabis among older adults. Clinical Gerontologist, 44(1), 25–31. https://doi.org/10.1080/07317115.2020.1746720CrossRefGoogle ScholarPubMed
Baumbusch, J., & Yip, I. S. (2022). Older adults experiences of using recreational cannabis for medicinal purposes following legalization. International Journal of Drug Policy, 108, 103812.CrossRefGoogle ScholarPubMed
Beedham, W., Sbai, M., Allison, I., Coary, R., & Shipway, D. (2020). Cannabinoids in the older person: A literature review. Geriatrics, 5(1), 1–14.CrossRefGoogle ScholarPubMed
Bertram, J. R., Porath, A., Seitz, D., Kalant, H., Krishnamoorthy, A., Nickerson, J., Sidhu, A., Smith, A., & Teed, R. (2020). Canadian guidelines on cannabis use disorder among older adults. Canadian Geriatrics Journal, 23(1), 135–142. https://doi.org/10.5770/cgj.23.424CrossRefGoogle ScholarPubMed
Bourbonniere, M., & Van Cleave, J. H. (2006). Cancer care in nursing homes. Seminars in Oncology Nursing, 22(1), 51–57. https://doi.org/10.1016/j.soncn.2005.10.007CrossRefGoogle ScholarPubMed
Calakos, K. C., Bhatt, S., Foster, D. W., & Cosgrove, K. P. (2017). Mechanisms underlying sex differences in cannabis use. Current Addiction Reports, 4(4), 439–453. https://doi.org/10.1007/s40429-017-0174-7CrossRefGoogle ScholarPubMed
Cerejeira, J., Lagarto, L., & Mukaetova-Ladinska, E. B. (2012). Behavioral and psychological symptoms of dementia. Frontiers in Neurology, 3. https://doi.org/10.3389/fneur.2012.00073CrossRefGoogle ScholarPubMed
Choinière, M., Peng, P., Gilron, I., Buckley, N., Williamson, O., Janelle-Montcalm, A., Baerg, K., Boulanger, A., Di Renna, T., Finley, G. A., Intrater, H., Lau, B., & Pereira, J. (2020). Accessing care in multidisciplinary pain treatment facilities continues to be a challenge in Canada. Regional Anesthesia & Pain Medicine, 45(12), 943–948. https://doi.org/10.1136/rapm-2020-101935CrossRefGoogle ScholarPubMed
Chou, R., Turner, J. A., Devine, E. B., Hansen, R. N., Sullivan, S. D., Blazina, I., Dana, T., Bougatsos, C., & Deyo, R. A. (2015). The effectiveness and risks of long-term opioid therapy for chronic pain: A systematic review for a national institutes of health pathways to prevention workshop. Annals of Internal Medicine, 162(4), 276–286. https://doi.org/10.7326/M14-2559CrossRefGoogle ScholarPubMed
Creighton, A. S., Davison, T. E., & Kissane, D. W. (2016). The prevalence of anxiety among older adults in nursing homes and other residential aged care facilities: A systematic review. International Journal of Geriatric Psychiatry, 31(6), 555–566. https://doi.org/10.1002/gps.4378CrossRefGoogle ScholarPubMed
Dahlke, S., Butler, J. I., Hunter, K. F., Toubiana, M., Kalogirou, M. R., Shrestha, S., Devkota, R., Law, J., & Scheuerman, M. (2024). The effects of stigma: Older persons and medicinal Cannabis. Qualitative Health Research, 10497323241227419. https://doi.org/10.1177/10497323241227419Google ScholarPubMed
Edinoff, A. N., Nix, C. A., Hollier, J., Sagrera, C. E., Delacroix, B. M., Abubakar, T., Cornett, E. M., Kaye, A. M., & Kaye, A. D. (2021). Benzodiazepines: Uses, dangers, and clinical considerations. Neurology International, 13(4), 594–607. https://doi.org/10.3390/neurolint13040059CrossRefGoogle ScholarPubMed
Fries, B. E., Simon, S. E., Morris, J. N., Flodstrom, C., & Bookstein, F. L. (2001). Pain in U.S. nursing homes: Validating a pain scale for the minimum data set. Gerontologist, 41(2), 173–179. https://doi.org/10.1093/geront/41.2.173CrossRefGoogle ScholarPubMed
Government of Canada. (2014). Action for Seniors Report.Google Scholar
GW Pharma Ltd. (2017). Product monograph including patient medication information: SATIVEX® delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).Google Scholar
Hadjistavropoulos, T., Janzen Claude, J.A., Hadjistavropoulos, H.D., Marchildon, G.P., Kaasalainen, S., Gallagher, R., & Beattie, B.L. (2011). Stakeholder opinions on a transformational model of pain management in long-term care. Journal of Gerontological Nursing, 37, 40–51. https://doi.org/10.3928/00989134-20100503-05CrossRefGoogle ScholarPubMed
Han, B. H., Funk-White, M., Ko, R., Al-Rousan, T., & Palamar, J. J. (2021). Decreasing perceived risk associated with regular cannabis use among older adults in the United States from 2015 to 2019. Journal of the American Geriatrics Society, 69(9), 2591–2597. https://doi.org/10.1111/jgs.17213CrossRefGoogle ScholarPubMed
Hemmingsson, E. S., Gustafsson, M., Isaksson, U., Karlsson, S., Gustafson, Y., Sandman, P. O., & Lövheim, H. (2018). Prevalence of pain and pharmacological pain treatment among old people in nursing homes in 2007 and 2013. European Journal of Clinical Pharmacology, 74(4), 483–488. https://doi.org/10.1007/s00228-017-2384-2CrossRefGoogle ScholarPubMed
Herrmann, N., & Gauthier, S. (2008). Diagnosis and treatment of dementia: Management of severe Alzheimer disease. Canadian Medical Association Journal, 179(12), 1279–1287.CrossRefGoogle ScholarPubMed
Husebo, B. S., Ballard, C., Cohen-Mansfield, J., Seifert, R., & Aarsland, D. (2014). The response of agitated behavior to pain management in persons with dementia. American Journal of Geriatric Psychiatry, 22(7), 708–717. https://doi.org/10.1016/j.jagp.2012.12.006CrossRefGoogle ScholarPubMed
Kalinowski, S., Dräger, D., Kuhnert, R., Kreutz, R., & Budnick, A. (2019). Pain, fear of falling, and functional performance among nursing home residents: A longitudinal study. Western Journal of Nursing Research, 41(2), 191–216. https://doi.org/10.1177/0193945918759958CrossRefGoogle ScholarPubMed
Kaufmann, C. N., Kim, A., Miyoshi, M., & Han, B. H. (2022). Patterns of medical cannabis use among older adults from a cannabis dispensary in New York State. Cannabis and Cannabinoid Research, 7(2), 224–230. https://doi.org/10.1089/can.2020.0064CrossRefGoogle ScholarPubMed
Livingston, G., Kelly, L., Lewis-Holmes, E., Baio, G., Morris, S., Patel, N., Omar, R. Z., Katona, C., & Cooper, C. (2014). Non-pharmacological interventions for agitation in dementia: Systematic review of randomised controlled trials. British Journal of Psychiatry, 205(6), 436–442. https://doi.org/10.1192/bjp.bp.113.141119CrossRefGoogle ScholarPubMed
MacNair, L., Kalaba, M., Peters, E. N., Feldner, M. T., Eglit, G. M. L., Rapin, L., El Hage, C., Prosk, E., & Ware, M. A. (2022). Medical cannabis authorization patterns, safety, and associated effects in older adults. Journal of Cannabis Research, 4(1), 50. https://doi.org/10.1186/s42238-022-00158-5CrossRefGoogle ScholarPubMed
McGolrick, D., & Frey, T. (2018). Nabilone for chronic pain management: A review of clinical effectiveness and guidelines – An update [Rapid Response Report]. The Canadian Agency for Drugs and Technologies in Health (CADTH).Google Scholar
Moffat, D. (2010). RAI – MDS overview in long term care.Google Scholar
Novotna, A., Mares, J., Ratcliffe, S., Novakova, I., Vachova, M., Zapletalova, O., Gasperini, C., Pozzilli, C., Cefaro, L., Comi, G., Rossi, P., Ambler, Z., Stelmasiak, Z., Erdmann, A., Montalban, X., Klimek, A., & Davies, P. (2011). A randomized, double-blind, placebo-controlled, parallel-group, enriched-design study of nabiximols* (Sativex®), as add-on therapy, in subjects with refractory spasticity caused by multiple sclerosis. European Journal of Neurology, 18(9), 1122–1131. https://doi.org/10.1111/j.1468-1331.2010.03328.xCrossRefGoogle ScholarPubMed
Nugent, S. M., Morasco, B. J., O’Neil, M. E., Freeman, M., Low, A., Kondo, K., Elven, C., Zakher, B., Motu’apuaka, M., Paynter, R., & Kansagara, D. (2017). The effects of cannabis among adults with chronic painandan overview of general harms a systematic review. Annals of Internal Medicine, 167(5), 319–331. https://doi.org/10.7326/M17-0155CrossRefGoogle ScholarPubMed
Seitz, D., Purandare, N., & Conn, D. (2010). Prevalence of psychiatric disorders among older adults in long-term care homes: A systematic review. International Psychogeriatrics, 22(7), 1025–1039. https://doi.org/10.1017/S1041610210000608CrossRefGoogle ScholarPubMed
Sommer, D. M., Zipursky, J. S., Giannakeas, V., Watt, J. A., Rochon, P. A., & Stall, N. M. (2020). Trends in the medical use of synthetic cannabinoids among older adults in Ontario, Canada. Annals of Internal Medicine, 173(7), 589–591. https://doi.org/10.7326/M20-0598CrossRefGoogle ScholarPubMed
Statistics Canada. (2019). National cannabis survey, third quarter 2019.Google Scholar
Swarm, R. A., Paice, J. A., Anghelescu, D. L., Are, M., Bruce, J. Y., Buga, S., Chwistek, M., Cleeland, C., Craig, D., Gafford, E., Greenlee, H., Hansen, E., Kamal, A. H., Kamdar, M. M., LeGrand, S., Mackey, S., Rachel McDowell, M., Moryl, N., Nabell, L. M., … Gurski, L. A. (2019). Adult cancer pain: NCCN clinical practice guidelines in oncology. JNCCN Journal of the National Comprehensive Cancer Network, 17(8), 977–1007. https://doi.org/10.6004/jnccn.2019.0038CrossRefGoogle ScholarPubMed
Turna, J., Belisario, K., Balodis, I., Van Ameringen, M., Busse, J., & MacKillop, J. (2021). Cannabis use and misuse in the year following recreational cannabis legalization in Canada: A longitudinal observational cohort study of community adults in Ontario. Drug and Alcohol Dependence, 225, 108781.CrossRefGoogle Scholar
Ware, M. A., Daeninck, P., & Maida, V. (2008). A review of nabilone in the treatment of chemotherapy-induced nausea and vomiting. Therapeutics and Clinical Risk Management, 4(1), 99–107. https://doi.org/10.2147/tcrm.s1132CrossRefGoogle ScholarPubMed
Whiting, P. F., Wolff, R. F., Deshpande, S., Di Nisio, M., Duffy, S., Hernandez, A. V., Keurentjes, J. C., Lang, S., Misso, K., Ryder, S., Schmidlkofer, S., Westwood, M., & Kleijnen, J. (2015). Cannabinoids for medical use: A systematic review and meta-analysis. JAMA – Journal of the American Medical Association, 313(24), 2456–2473. https://doi.org/10.1001/jama.2015.6358CrossRefGoogle ScholarPubMed
Wilson, M. M. E., Masterson, E., & Broglio, K. (2019). Cannabis use among patients in a rural academic palliative care clinic. Journal of Palliative Medicine, 22(10), 1224–1226. https://doi.org/10.1089/jpm.2018.0534CrossRefGoogle Scholar