C0406 - General Use and Education Surrounding Endocannabinoids for Inflammatory Bowel Disease

Monday, October 24, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Akshay Kapoor, MD, MSPH

Yale New Haven Hospital
New Haven, CT

Akshay Kapoor, MD, MSPH¹, David Hass, MD²
¹Yale New Haven Hospital, New Haven, CT; ²Yale New Haven Hospital, Hamden, CT

Introduction: In an era of decriminalization and expanded access, the use of endocannabinoids, namely marijuana and non-pharmaceuticals, for symptom control of IBD has increased amongst the general public¹. We hypothesize that there is an increasing knowledge gap for U.S. Gastroenterologists on how to best advise and prescribe in this realm. This represents the first survey of U.S. Gastroenterologists on current knowledge gaps regarding endocannabinoids in relation to IBD.

Methods: A simple non-random probability sampling survey was distributed to American College of Gastroenterology (ACG) active membership in fellowship training and beyond. Participants answered a series of six demographic questions, and nine investigative questions regarding their current knowledge surrounding endocannabinoids, existing prescription practices, and desire for opportunities for further educational development. Respondents were able to answer all, or their preferred choice of questions.

Results: In total, 76 gastroenterologists were surveyed. There were no statistically significant geographical, gender based, or stage of practice variations (p >0.05). Findings are displayed in Table 1. These results are unsurprising as only 37% of surveyed gastroenterologists reported receiving any formal education on these topics. 86% of respondents stated that they would be interested in learning more about endocannabinoid directed adjunctive therapy for patients with IBD. A breakdown of how U.S. based Gastroenterologists would like to receive this education is outlined in Figure 1.

Discussion: In a backdrop of increased acceptance and use amongst patients, our survey indicates that there remains a significant knowledge gap amongst U.S. Gastroenterologists regarding the function and physiology of the Endocannabinoid System and the existing research as it relates to modulating disease and symptom activity, and more generally, current treatment options. Fortunately, there is a strong desire amongst U.S Gastroenterologists to learn more about this topic, and therefore an opportunity ripe for educational development. It is our hope that this survey aids in the formation of targeted educational interventions that can be tailored to this diverse group of physicians to help with improve patient outcomes and the natural history of inflammatory bowel disease.
¹Gerich, M. et al. Am J Gastroenterol. Feb 2015, p208-14

Figure: Figure 1. Preferred modality of formal education on endocannabinoid system by stage of practice

Knowledge surrounding endocannabinoids	n	%
% Correct endocannabinoid receptor pathways identified	33/57	57.9
% Correct ECS receptor activation and side effects	22/57	38.6
% Correct disease/symptom modulating effects in IBD	32/57	56.1
% Correct currently available endocannabinoid products/therapies	23/58	39.7

Current practice surrounding endocannabinoids and IBD
Ask patient if they are using cannabis, tetrahydrocannabinol, cannabidiol, or other derived products specifically for IBD symptoms	38/59	64.4
Review methods of use (inhalation, ingestions, etc.)	20/59	33.9
Discuss endocannabinoid directed therapy for ongoing IBD symptoms	10/59	16.9
Steer patients who may clinically benefit from these therapies to appropriate procurement sites and resources	12/59	20.3

Barriers to use in their practice
"Uncertain of the risks vs. benefits of endocannabinoids" or "not comfortable counseling"	36/59	61.1
"Uncertain who would be a good candidate for endocannabinoid use, or who would be at higher risk of adverse effects"	34/59	57.6
"Uncertain when to use this therapy in conjunction with 'traditional' treatments"	33/59	55.9
"Uncertain when in patient's disease course to counsel them on this type of therapy"	24/59	40.7

Regulatory landscape
Reported good grasp about regulations/statutes surrounding endocannabinoids in their practice area	6/59	10.1
Reported not knowing where to get information on this topic	23/59	38.9

Table: Table 1. Respondent Results Surrounding Endocannabinoids and IBD

Disclosures:

Akshay Kapoor indicated no relevant financial relationships.

David Hass indicated no relevant financial relationships.

Akshay Kapoor, MD, MSPH¹, David Hass, MD². C0406 - General Use and Education Surrounding Endocannabinoids for Inflammatory Bowel Disease, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.