THC was prescribed only to severely ill children in Vienna, with significant documentation gaps | Research

The takeaway

A retrospective analysis of 32 pediatric patients prescribed THC at a Vienna tertiary center found it was used exclusively for severely ill children (average 9.4 diagnoses each), mostly in palliative contexts, with notable gaps in dosing and indication documentation.

Pediatric pharmacologists, palliative care specialists, medical cannabis regulators

32 patients with an average of 9.4 diagnoses and 13.5 other medications each

What the researchers found

The 32 pediatric patients who received THC had an average of 9.42 diagnoses and were treated with an average of 13.52 other drugs simultaneously. Brain cancer and genetic diseases were the most common diagnoses. Eleven of 32 patients (34%) died by the end of the study period, indicating predominantly palliative use. Significant gaps in documentation of indications, dosage, and treatment duration were identified.

Why it matters

This study reveals both the extreme caution applied to pediatric THC prescribing (only the sickest patients) and the paradox that even in a controlled medical setting, prescribing documentation remains inadequate.

The numbers in context

32 patients; mean 9.42 diagnoses per patient; mean 13.52 concurrent medications; brain cancer and genetic diseases most common; 11/32 (34%) died during study period

How the study worked

Retrospective data analysis of all THC prescriptions at the Department of Pediatrics and Adolescent Medicine, Medical University Vienna, from 2016-2018. Patient records reviewed for diagnoses, concurrent medications, and prescribing documentation.

What this study cannot tell us

Single-center retrospective study. Very small sample of 32. Documentation gaps may reflect charting practices rather than actual prescribing quality. Austrian regulatory context may not generalize.

How to read the evidence

Single-center retrospective analysis providing descriptive data, but very small sample and documentation limitations constrain findings.

When this study was published

Published 2023 using 2016-2018 data

The bigger picture

The gap between the severity of illness in children receiving THC and the quality of documentation about their THC treatment represents a patient safety concern that needs addressing as pediatric cannabis medicine evolves.

Questions still open

Would standardized pediatric cannabis prescribing templates improve documentation? Is the restriction of THC to the sickest children appropriate, or are moderately ill children being undertreated?

Common questions

Which children receive medical THC?

In this Vienna hospital, only severely ill children received THC. They had an average of 9.4 diagnoses each, mostly brain cancer or genetic diseases, and a third died during the study period, indicating predominantly palliative use.

Is pediatric THC prescribing well documented?

Not in this study. Significant gaps in documentation of indications, dosage, and treatment duration were found, raising patient safety concerns.

Read the original research

Tetrahydrocannabinol in Pediatrics: Room for Improvement?

Medical cannabis and cannabinoids, 6(1), 125-129

View on PubMed ↗Publisher’s paper ↗

Citation

de Gier, Charlotte; Scharinger, Christian; Stark, Rosa H; Steurer, Philipp; Klier, Claudia M. (2023). Tetrahydrocannabinol in Pediatrics: Room for Improvement?. Medical cannabis and cannabinoids, 6(1), 125-129. https://doi.org/10.1159/000533607