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West Virginia MedicalCannabis: Patient andPhysician Interest SurveyResults and Other DataLoretta Haddy, PhD, MSState EpidemiologistDecember 14, 2017WV Medical Cannabis Advisory Board
Presentation Summary Objectives for Data Set AnalysesPatient Interest SurveyProvider Interest SurveyOther Available Data SystemsMethods and Result Narrative Statements for Each Data SetGraphics for Data SummariesCounty and Public Health District MapsZip Code Maps: Patient Survey, Cancer Data, Medicaid andMedicare Data1
Data Objectives for Patient SurveyMethod:Survey online October 14, 2017 - November 20, 2017Results: 6,174 responses (62 by mail and 6,112 online) Patient provided zip code and interest in medical cannabis 6,003 surveys analyzed, 171 were out of state zip codes so notincluded in analysis Patients diagnosed with serious medical condition(s) Mapped serious medical conditions by patient zip code Most respondents indicated they were a patient or a familymember was a patient Patients indicated how far they would travel to a dispensary Most frequent “other condition” response was related toanxiety disorders2
Results - Patient SurveyNumber of ResponsesReported Interest in Use of Medical Cannabis,West Virginia, 20175,0004,0334,0003,0001,8132,0003646111,0000I am a patient with My family membera serious medicalhas a seriouscondition.medical condition.I am a caregiver ofa patient with aserious medicalcondition.Reported RoleOther (pleasespecify)3
Results - Patient Survey (cont’d)Counties from which Patient Respondents Reported,West Virginia, 20174
Patient Survey Respondents by Zip Code, 20175
Results - Patient Survey (cont’d)Number of RespondentsAge Ranges of Patient Respondents,West Virginia, -18 years ofage19-25 yearsof ageNote: Respondents may have selected more thanone option.26-35 yearsof age36-45 yearsof ageAge Ranges46-55 yearsof age56 years ofage and older6
Results - Patient Survey (cont’d)Number of ResponsesDiagnoses Reported by Patient Respondents,West Virginia, 752245737051171120Serious Medical ConditionNote: Respondents may have selected more than one condition.7
Results - Patient Survey (cont’d)Types of Diagnoses Listed Under "Other, Please Specify" as Indicatedby Patients, West Virginia, 2017Percent of “Other” ResponsesType of giaGenetic DisorderGlaucomaHepaticInfectious DiseaseInjuryMalignanciesMental/Behavioral HealthMusculoskeletal UnspecifiedUnspecified 1383325%198171152163257220%2012315%980215201837998
Results - Patient Survey (cont’d)Patients Indicating Communication with Their HealthCare Provider Regarding Medical CannabisWest Virginia, 2017Unsure15%Other4%Yes43%No38%9
Results - Patient Survey (cont’d)Health Care Provider With Whom PatientsDiscussed Use of Medical Cannabis,West Virginia, 2017Number of 7685465000Medical Doctor(MD)Doctor ofOsteopathicMedicine (DO)NursePractitioner(NP)PhysicianAssistant (PA)Type Of Health Care ProviderUnsureOther (pleasespecify)10
Results - Patient Survey (cont’d)Specialty of Health Care Provider as Indicated by Patient, WestVirginia Medical Cannabis Patient Interest Survey, 20172370Family MedicineUnsurePsychiatryNeurological SurgeryInternal MedicineRheumatologyOrthopedic SurgeryGastroenterologyHematology & OncologyEndocrinologyHospital-BasedPediatric SubspecialtiesEmergency MedicineNephrologyCardiologyGeneral SurgeryUrologyObstetrics & GynecologyInfectious DiseaseAddictionologistPulmonologyAllergy & sticsOphthalmologyDermatologyPathology Anatomic and ClinicalPlastic 0NUMBER OF RESPONSES1,500.02,000.02,500.0
Results - Patient Survey (cont’d)Patients Indicating Designation of Caregiver to ObtainMedical Cannabis, West Virginia, 2017Yes 22%Unsure 29%No 49%12
Results - Patient Survey (cont’d)Ability and Willingness of Respondents to Drive toPurchase Medical Cannabis,West Virginia, 2017No6%Unsure 10%Yes 84%13
Results - Patient Survey (cont’d)Number of ResponsesDistance Respondents Indicated Willingness to Driveto Purchase Medical Cannabis,West Virginia, -10 miles11-25 miles26-50 miles50 or moremilesOther (pleasespecify)Number of Miles14
Results - Patient Survey (cont’d)Number of ResponsesPreferred Form of Medical Cannabis as Indicated byPatient Respondents,West Virginia, ms,orincluding gel, nebulizationcreams or(excludingointmentsdry leaf orplant form)TincturePreferred Form of CannabisLiquidNopreference15
Data Objectives for Physician SurveyMethod:Survey available October 24, 2017 – November 14, 2017 Medical boards sent email to licensed physicians with link to surveyResults: Total of 1,455 physicians completed online survey 1,190 physicians interested; 265 not interested in medical cannabis Physicians indicated practice environments, specialties, andcounties in which they practice 28 specialties indicated by respondents Physicians indicated the serious medical conditions for which theyprovide care Physicians asked to indicate awareness of the 4-hour training courserequirement for certifying physicians; most were not aware Physicians indicated interest in medical cannabis treatment16
Results - Physician SurveyPractice Environment of Physicians,West Virginia, 2017575Number of Respondents600500400275300188152200781000Private Practice Group Practice Hospital SystemFQHC orPrimary CareClinicOtherPractice Environment17
Results - Physician Survey (cont’d)SpecialtySpecialties Indicated by Physicians,West Virginia, 2017Family MedicineInternal MedicineEmergency MedicineHospital-basedPsychiatryOrthopedic SurgeryAnesthesiologyObstetrics & GynecologyPediatricsGeneral SurgeryPediatric SubspecialtyHematology & DermatologyEndocrinologyUrologyInfectious DiseaseNephrologyRheumatologyPlastic SurgeryAllergy & 8765505018111767645957565251100Number of Respondents15020023825018
Results - Physician Survey (cont’d)Counties Where Physicians Practice, West Virginia, 201719
Serious Medical Conditions Combined Related disorders were combined: Seizure Disorders Epilepsy Intractable Seizures Spasticity Disorders Amyotrophic Lateral Sclerosis (ALS) Huntington’s Disease Parkinson’s Disease Multiple Sclerosis (MS)20
Results - Physician Survey (cont’d)Provide Care for Serious Medical Conditions, West Virginia, 201716001,433Number of 74442411181420Serious Medical Conditions21
Results - Physician Survey (cont’d)Respondents Indicating Awareness of 4-hour Training Course Requirement,West Virginia Physician Survey, 2017Yes36%No64%22
Results - Physician Survey (cont’d)Interest Shown by Respondents,West Virginia Physician Survey, 2017No18%Yes82%23
Data Objectives for Other Data SystemsMethod: Most recent three years of available data Determine location of person with serious medical conditions ICD 9-10 code data for serious medical conditionsResults: PEIA active membership with serious medical conditions West Virginia HIV/AIDS Registry Patients Living with HIV/AIDS(PLWHA) by Public Health District in 2017 West Virginia Cancer Registry (January 2012 - December 2014)incidence data by zip code Medicaid (January 2015 - June 2017) by zip code Medicare (January 2015 - June 2017) by zip code24
Results - PEIAWV Public Employees Insurance Agency (PEIA) Currently has 152,000 insured active members Data Set: Fiscal Years January 2015 – June 2017 Count of active members with claims that includediagnosis codes for the applicable serious medicalconditions Patient duplicates have been removed from eachcondition claim count; however, patients with multipleconditions are represented within each condition total The HIPAA Privacy Rule does not allow PEIA to providediagnoses information by geographic area in a unit smallerthan a stateSource: PEIA25
Results - PEIA (cont’d)PEIA Claims by Medical Condition,West Virginia, January 2015 - June 2017Number of 001,33266071995280Source: PEIASerious Medical Conditions26
Results - PEIA (cont’d)PEIA Claims by Medical Condition,West Virginia, 2015-2017Sickle Cell Anemia SpasticityHIV/AIDS 1.0%Disorders 1.0%3.0%PTSD19.1%Neuropathies26.2%Other9.4%Chronic Pain19.9%Cancer25.4%Source: PEIASeizureDisorders4.0%Crohn's Disease2.0%27
Results - HIV/AIDS RegistryHIV/AIDS Registry Data West Virginia residence at the time of diagnosis who are stillliving in 2017 Annual review of people living with HIV/AIDS (PLWHA) withreported lab results indicating still in care Small number of cases ( 5) prevented mapping data by zipcode Conduct National Death match two times a year to identify ifliving Annual case comparison with other states - deletes duplicates28
People Living with HIV/AIDS by District in 201729
Results - Cancer RegistryCancer Registry Data Number of invasive cancer (and in situ cancer) for the years2012-2014 by zip code Incidence cases reported by zip code based on patient’saddress at the time of diagnosis30
Invasive & In Situ Cancer, January 2012 – December 201431
Results - MedicaidWest Virginia Medicaid Serious Medical ConditionClaims Data Data generated from West Virginia Medicaid Data Warehouse Data Set: Data from January 2015 - June 2017 Used ICD9/10 codes for serious medical conditions Count of active members with claims that include diagnosiscodes for the applicable serious medical conditions by zipcodeSource: West Virginia Medicaid Data Warehouse32
Results - Medicaid (cont’d)Medicaid Serious Medical Condition Claims,West Virginia, January 2015 - June 201768,117Number of ,00010,0000201520162017Year of ClaimSource: West Virginia Medicaid Data Warehouse33
Results - Medicaid (cont’d)Medicaid Claims by Serious Medical Condition,West Virginia, January 2015 - June 2017Number of ,00010,0008,578 10,6923,738 2,2735,3482452130Source: West Virginia Medicaid Data WarehouseSerious Medical Condition34
Results - Medicaid (cont’d)Medicaid Claims by Medical ConditionWest Virginia, January 2015-June 2017Chronic Pain18%SeizureDisorders 18%Sickle Cell 1%PTSD 8%Other23%Neuropathies 6%Cancer 41%Terminally Ill 1%HIV/AIDS 2%Source: West Virginia Medicaid Data WarehouseSpasticityDisorders 4%Crohn’sDisease 3%35
Medicaid Medical Condition Claims, Zip Code 2015-201736
Results - MedicareWest Virginia Medicare Beneficiaries Data Data generated from Quality Insights Data Set: Count of active members that include diagnosis codes forthe applicable serious medical conditions Patient duplicates have been removed from eachcondition claim count; however, patients with multipleconditions are represented within each condition totalSource: Quality Insights37
Results - Medicare (cont’d)Medicare Cases by Disease Group,West Virginia, 2017140,000133,796Number of 1,057 2,5633,213 1,13914,273768,7966420Serious Medical ConditionSource: Quality Insights38
Results - Medicare (cont’d)Medicare Cases by Disease Group,West Virginia, 2017Sickle Cell Anemia 1%ChronicPain13%Cancer67%Seizure ource: Quality InsightsSpacicity Disorders4%TerminallyIll 1%Crohn's Disease2%39
Medicare Serious Medical Conditions by Zip Code, 2015-201740
Patient Survey, Cancer, Medicaid & Medicare by Zip Code41
AcknowledgementsTHANK YOUMedical Cannabis Data TeamAllysa CrewsAlex DanielsBijal PatelJessica ShlitzMelissa ScottAshley SimmonsTonya Yablonsky42
Contact InformationLoretta Haddy, PhD, MSState EpidemiologistWest Virginia Department of Health and Human ResourcesBureau for Public HealthCommissioner’s OfficePhone: (304) 356-4077Fax: (304) 558-1035Email: Loretta.E.Haddy@wv.gov43
December 14, 2017 WV Medical Cannabis Advisory Board. . West Virginia, 2017 0 50 100 150 200 250 Family Medicine Internal Medicine Emergency Medicine Hospital-based Psychiatry Orthopedic Surgery Anesthesiology . living in
