Tment, A.Li.Sa, 16121 Genova, Italy; [email protected] (C.
Tment, A.Li.Sa, 16121 Genova, Italy; [email protected] (C.C.); [email protected] (M.S.R.); [email protected] (B.R.) Correspondence: [email protected]: Russo, E.; Cannas, C.; Rivetti, M.S.; Villa, C.; Rebesco, B. Innovative Clinical-Organizational Model to make sure Appropriateness and High-quality within the Management of Medical Cannabis: An Italian Regional Case. Healthcare 2021, 9, 1425. https://doi.org/10.3390/ healthcare9111425 Academic Editor: Jose M. Moran Received: 14 Mouse supplier September 2021 Accepted: 20 2-Bromo-6-nitrophenol web October 2021 Published: 22 OctoberAbstract: This work focuses around the clinical-organizational model implemented in an Italian area (Liguria) to streamline the access procedures to galenic cannabis preparations. The competent regional overall health care authority that requires care of tracing a virtuous path to get frequent, uniform and shared protocols and guarantee high standards of care is actually a.Li.Sa. (Azienda Ligure Sanitaria), a public organization with all the function of coordination, path and governance of your wellness care in the regional hospitals and well being facilities. To this objective, different functioning groups and also a board meeting have been setup together with the main role to define and create technical requirements to become applied towards the prescription, preparation and dispensing of pharmaceutical types based on therapeutic cannabis. In specific, the galenic preparations offered by the Italian Ministry of Well being, described in detail inside the regional normal operating protocols, are described and discussed. In addition, the most considerable information monitored from 2018 to 2020 and collected by hospitals along with the evaluation of those derived from local pharmacies and well being facilities are presented, discussed and compared in regards to their adherence and coherence together with the Italian Institute of Well being (ISS) data. Keywords: healthcare cannabis; galenic preparations; common operating protocols; monitoring data1. Introduction In the beginning of the 1900s, the United states of america was the initial nation starting a genuine prohibition of narcotic drugs. In 1912, the “International Opium Convention” was signed inside the Hague [1] and in 1914, the Harrison Narcotics Act [2] restricted the sale of opiates and cocaine. Cannabis was removed from US Pharmacopoeia in 1942. In 1923, the US Treasury Department’s Narcotics Division banned the sale of all legal narcotics, such as cannabis. In reality, in 1937 by means of the “Marihuana Tax Act” [3], the cultivation, trade and use of Indian hemp was banned. A healthcare interest in cannabis therapeutics arose inside the 1940s when the American chemist Roger Adams chemically identified and synthesized cannabidiol (CBD), cannabinol (CBN) and several other molecules similar to tetrahydrocannabinol (THC), obtaining in 1942 a patent from the CBD isolation strategy [4,5]. In 1963, the Israeli chemist Raphael Mechoulam fully elucidated the properties and structure of THC, recalling and confirming Adams’ discovery [6]. Beginning in the discovery of phytocannabinoids, the investigation turned toward the identification with the molecular pathways and receptor proteins involved in the signal transduction responsible for the many cannabis effects [7]. The discovery of cannabinoid receptors CB1 [8] and CB2 [9] dates to the 1990s when the receptor proteins, to which each exogenous and endogenous compounds have been in a position to bind, had been identified. At first, CB1 receptors were discovered inside the brain, with the highest concentrations demonstrate.
