Brooke Worster, MD, is Chief Medical Officer at EO Care and the Director of the Division of Supportive Oncology at Jefferson Health, and Program Director of Cannabis Medicine for the Science and Business Master’s Program at Sidney Kimmel Medical College.
In her work with EO, her research and clinical practice, Dr. Worster has been a pioneer in assessing the effectiveness of medical cannabinoids as an alternative or addition to prescription pharmacotherapies for symptom management. For Dr. Worster, advancing evidence-based research and guided cannabinoid care to support those in need is a critical endeavor worth pursuing.
Dr. Worster shares her perspective on the current cannabinoid care landscape, the conversations clinicians are having, and what access to alternative relief options can mean for patients.
1. What is the current state of cannabinoid care for symptom management as a clinical provider?
Patients want to explore cannabinoids for symptom management, but are often not getting clear guidelines or messaging on how to do so in an effective manner. There are well-documented studies showing that cannabinoids are self-prescribed by millions of people across the country, but efficacy can be sub-optimal without the right guidance. The interest is there.
2. How often are you having conversations about cannabinoid care? What has spurred any rise in interest?
I have conversations about cannabinoid care in a clinical setting more often than you would think. There is data showing that ~30 percent of patients with any kind of ongoing medical issues use cannabinoids in some capacity. Often times for symptom management or symptom relief. Anecdotally, I would say that aligns with what we see. Increasing awareness that cannabinoids can be helpful remains a hurdle we’re actively overcoming. Greater guidance would go a long way in helping clinicians have informed conversations.
Cannabinoids are unique. They straddle both the natural, nutraceutical side of care as well as pharmaceutical. They are somewhat of a unicorn in this sense, playing in a grey area where providers can lack confidence in its administration despite growing real-world evidence of the benefits it provides patients. It’s why there is a critical demand for education and guidance on cannabinoids. This is the catalyst for change.
3. What do you believe are the primary benefits and risks of cannabinoid based symptom management in a supportive oncology setting?
The fact that up to 40 percent of those in cancer treatment report using some form of cannabinoids for symptom management purposes shows that there are undoubtedly benefits being seen across the population. The main benefit of cannabinoids is managing side effects that come from cancer-related treatments or that ail those suffering with cancer, as well as symptom relief, from pain, nausea, sleeplessness, and anxiety.
What makes guidance so challenging is that cannabinoids effect everyone differently. Often, it is unique to the individual. There are different levels of symptom relief and each person’s tolerance may be different based on myriad factors, including general health, prior recreational use, and other medications being taken. There is an initial trial-and-error that leads to optimal results but requires guidance during the initial phases. This can be in the form of dosage recommendations, administration methods, and more. Most importantly, however, there needs to be a feedback loop that captures efficacy, understands results, and modifies care plans appropriately.
4. What could those in the cannabinoid industry do to better meet the needs of patients and clinicians?
We must – collectively – wrap our brains around real-world data collection and integration of this information into healthcare systems. The industry cannot afford to continue to put its head in the sand when it comes to cannabinoids. We must be an active part of the conversation to ensure the proper regulation, guardrails, and guidance that lead to better patient outcomes and more choice for millions in need of symptom relief.
Together, we must be pragmatic. There is growing evidence from real-world scenarios that cannabinoid care works. There are also emerging channels for capturing patient-reported data that lead to a stronger understanding of efficacy. It will be important help people access cannabinoid care more easily and more equitably.
5. What types of cannabinoid-focused research do you believe would benefit patients and practices the most?
There is going to be a new reality for cannabinoid science. Mimicking traditional pharmaceuticals is likely not the path forward and could cost millions of people a chance at symptom relief. Realistically, there is a viable path forward where we can get ongoing real-world data from people using cannabinoids, and tag it to products and outcomes and disease states. Using patient reported data together with more strictly produced cannabinoids, we can understand correlations and infer appropriate guidance that gives providers and patients confidence.
Bigger picture, the healthcare industry, the populations it serves, and business entities must be comfortable being partners. Patient reported data on cannabinoid care is beginning to flow into the industry – both in the form of stories and self-reported outcomes. We all, including healthcare, must embrace this collaboration. It will be the fastest, cleanest way, to get meaningful data to move cannabinoid care into the mainstream.
Bonus: What to you enjoy most about your role as a CMO and an advisor for EO Care?
There is a critical need for efficacy data and clinical guidance for cannabinoid care. Digital health platforms – that bring together responsibly produced cannabinoids, clinical guidance and oversight, and patient-reported data – are the connective tissue. They are uniquely positioned to engage all appropriate players in an active, fruitful dialogue. That’s what EO Care can do.
Beyond that, anything that helps people become more knowledgeable about cannabinoid care – and what data is already out there – is rewarding. Raising the bar a little bit every day will aid everyone in becoming more educated and shifting a conversation that can unlock symptom relief for millions in a more cost-effective and efficacious manner.
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