NIAMEDIC - THE BEST LAST RESORT FOR CHRONIC PAIN PATIENTS
I met Alon Blatt of NiaMedic at a panel discussing the benefits and challenges of the cannabis industry earlier this year. I was very impressed when I started learning about this patient-centric company and how they are helping to improve patient outcomes by prescribing cannabis treatment in a clinical-trial setting and using data to drive desired results (which, of course, is right up my alley). Alon agreed to an exclusive interview with S Kern Consulting:
SMK: How does NiaMedic find its patients?
AB: Right now we have a healthy mix between patients who find us and patients who are referred by their doctors or physicians. Initially most of our patients found us through published articles, marketing or searches for cannabis treatments. But once we started treating patients in clinics, doctors quickly started realizing the benefits we bring to them and their patients and since then have really been doing about half of the patient recruitment for us.
SMK: Explain how clinical research comes into play.
AB: Our process collects very detailed and comprehensive amounts of information. The initial visit with the patient lasts about an hour and a half and really helps us get a good understanding of the unique patient situation and medical history. Collecting this information benefits us on two levels - the first is to really get to know our patients and the second is to obtain a solid baseline for clinical research. Later we use this information for retrospective study publication. We are an accredited site in Israel and we work with UCLA here in Los Angeles so we can also offer research services for companies who want to clinically test their products. Unlike a pharmaceutical company, we have no financial interest in any of our studies. We are not testing our own products which gives us more independence.
SMK: Who are your target patients?
AB: Our patients are anybody who suffers from chronic conditions with chronic symptoms: pain, sleep disorders, different neurological conditions, rheumatological conditions, and of course, oncology. Overarching the need for palliative care treatments is the geriatric population because they tend to suffer from these conditions at a greater rate than the rest of the public. We also work with patients experiencing PTSD, mood and sleep disorders, and anxiety, and a huge part of our practice is palliative care. Our focus is improving the quality of life by ensuring symptom management. We do not claim to cure the diseases, we help people cope with their diseases and improve their quality of life.
SMK: What kind of data does NiaMedic collect?
AB: As we discussed earlier, we collect a lot of information starting at the patient intake interview, which typically lasts about 90 minutes. We have noticed that in the United States there is a lot of miscommunication between providers and treatment is segmented. A patient has a neurologist for this problem, a cardiologist for that problem, etc. So we actually do our own comprehensive medical history and assessments starting with a basic physical and then perform neurological, cardiological, sleep, pain, and quality of life assessments to get a good holistic understanding of the patients’ conditions. All of this data is collected in a way that is HIPAA compliant.
SMK: What are the benefits to the physicians who work with NiaMedic?
AB: There are a lot of benefits to the physicians:
Physicians are now able to offer this highly sought-after service in their clinic. So many patients are looking for help with cannabis and the only other options are dispensaries.
We often bring patients to a clinic and the patients end up joining the doctor’s practice so they can be seen by a doctor in the same location as the cannabis treatment.
Offering this service brings increased traffic of existing patients. These patients who are undergoing treatment with cannabis usually require some follow-up with the practicing physician during and after treatment.
A big part of what we do is the titration process and case management which takes place over a month. During this time we do not assume care of the patient. We will inform the doctor and the patient during this month and advise the patient to see his or her doctor to talk about any concerns, symptoms and/or medication adjustment as we do not take over the drug regimen changes. As an example, if a patient had been prescribed opioids, he or she would need to schedule an appointment with the doctor to decrease the dosing and change the drug regimen as the cannabis treatment is titrated.
We pay rent to the hosting physicians.
For physicians who are interested in clinical research, we include them in the clinical research publication and they are credited.
Most importantly is the ability for physicians to improve the quality of life of their patients. Many doctors have done everything they can to help their patients but have not been successful. This gives them another option in the care of their patients without themselves diving into prescribing cannabis treatment.
SMK: What are the benefits to the patients who enroll in a clinical trial with NiaMedic?
AB: The benefit is to be treated using evidence and research-backed protocols that have been developed over a decade and to be treated using cannabis by professional medical staff as opposed to on their own or by advisors of sorts. Over 93% of our patients reported experiencing symptom improvement with our treatment and 0% reported deterioration. Further, in one particular study we conducted, the median level of pain prior to treatment was 10 out of 10 on the pain scale. After treatment, the median level reported was decreased to 2.5 out of 10.
SMK: How does NiaMedic determine a treatment plan for a patient? What factors are important for developing that treatment plan?
AB: We start every patient with a screening process to make sure they do not have significant contraindications. Throughout this comprehensive process the patients fill out information and meet with the doctor. We then customize the treatment plan through these steps:
We match symptoms and the appropriate products based on chemical profile of the medication. We actually collect COAs (Certificates of Analysis) from different companies rather than relying on claims.
NiaMedic has developed unique dosing methodologies where we use microdosing to help the patient reach optimum levels of therapeutic effect while minimizing potential side effects.
We ensure an appropriate route of administration. Some people are very scared when they come to us and we make sure we find a route that is comfortable and effective for the treatment plan.
We analyze the drug/drug and cannabis/drug interactions. We have pharmacists in Israel who analyze drug on drug and cannabis on drug interactions as most of our patients are experiencing polypharmacy.
We provide one month of case management. This includes weekly check-ins where our medical staff call the patient and slowly titrate up to achieve treatment goals while trying to avoid any potential side effects.
SMK: Is the cannabis prescribed by a physician? Do you work with other healthcare personnel?
AB: Yes but when it comes to cannabis, there are no prescriptions but rather recommendations by a physician. Across our platform we use doctors. It is a medical treatment and therefore there is no medical treatment without a doctor. We have nurses, occupational therapists, pharmacists, and other medical staff on our team as well.
SMK: Does NiaMedic communicate and/or coordinate the plan of care with the patient’s physicians?
AB: Absolutely. We start by asking the referring physician to communicate their treatment goals. This is important because sometimes the physician goals may deviate from the patient’s goals. As an example, a patient may state that he or she wants to improve the quality of sleep but the physician may feel the patient is on too many opioids and the primary goal for the doctor would be to wean off of the opioid treatment.
Next, if there is anything we need to communicate during the 1 month of case management, we will communicate with the doctor or send the patient to follow up with the treating physician.
Finally, at the end of the 1 month case management period, we provide a summary with all treatment goals, what happened throughout the treatment, and what the results were. The physicians understand that we are not taking over care of the patient and we ensure that we are not contributing to the miscommunication between treating physicians.