Pilot Study of MC in Paediatric Palliative Care

The goal of this pilot study is to explore the feasibility and acceptability of a medicinal cannabis clinical trial into easing the symptoms of children undergoing palliative care for non-oncological conditions. The trial will evaluate the study design including recruitment strategy, medication tolerability, duration and outcomes to determine acceptability and feasibility for participating families. The data collected will then be used to design a full-scale multi-centre trial.Participants will be randomly allocated to receive one of two medicinal cannabis products. Neither the participants nor researchers will know the study drug allocation until the end of the trial.

Inclusion Criteria:Males and females aged 6 months to 21 years of age;Receiving care in the Victorian Paediatric Palliative Care Program for a non-oncological condition;Pain, dystonia and/or gut dysfunction parent-rated symptom score above threshold, defined by rating on the relevant revised Memorial Symptom Assessment Scale (MSAS) question(s) of:Frequency: "Frequently" or "Almost Constantly", ANDSeverity: "Moderate", "Severe", or "Very Severe", ANDDistress: "Quite a bit", or "Very much";No changes in medication or other interventions in the two weeks prior to randomization;Participant and family have the ability to comply with the protocol requirements, in the opinion of the investigator;Agrees not to drive for the duration of the study.Exclusion Criteria:Non-English speaking parents.Participant history of psychosis, schizophrenia, bipolar disorder, or major depressive disorder, or a first degree family history of psychosis.Taking medications which are known to interact with medicinal cannabis: warfarin, mTOR inhibitors (e.g sirolimus, tacrolimus), anti-cancer agents, citalopram >20mg/day, escitalopram >10mg/day.Abnormal liver function tests defined as ALT > 3 x ULNCurrent use of illicit drugs or medicinal cannabis, or use in the 4 weeks prior to screeningPregnant or intending to become pregnant during the study, or breastfeeding.History of clinically significant suicidal thoughts in the prior 12 months.Life expectancy less than 3 months in the opinion of the investigatorsAllergy to any of the components in the investigatory products (eg sunflower oil)Diagnosis of a malignant condition