Cannabis for medical purposes: A cross-sectional analysis of health care professionals' knowledge

Implementation of Perioperative Anesthesia Considerations for Military Veterans Who Consume Cannabis: A Quality Improvement Project

PURPOSE

As no widely accepted recommendations or guidelines on perioperative management for the cannabis-consuming patient exist, this quality improvement project aimed to identify and implement evidence-based recommendations for cannabis-consuming patients throughout the perioperative period. The objectives of this project were (1) to improve anesthesia providers' knowledge on how to care for cannabis-consuming patients, (2) to increase anesthesia providers' self-efficacy in caring for cannabis-consuming patients, and (3) to assess the frequency of utilization of the given evidence-based recommendation.

DESIGN

This quality improvement project incorporated a pretest-posttest design.

METHODS

Nurse anesthetists, resident nurse anesthetists, and nurse practitioners (staff) in an urban veteran's hospital participated in the project. Following the Johns Hopkins Evidence-based Practice Model, a literature review was conducted via PubMed, Cochrane Library, and Cumulative Index to Nursing & Allied Health Literature to determine anesthetic considerations for cannabis consumers. Evidence was synthesized and translated into a live educational seminar that was evaluated via an electronic questionnaire before and after (pretest-postest) the seminar. Frequency of education utilization was measured via sticker poster system. Normality tests were conducted using Jamovi computer software. Wilcoxon signed-rank tests were pursued due to the skewed data distribution.

FINDINGS

Results from 22 articles informed content for the live educational seminar; 26 staff participated in the pretest-posttest. Specific preoperative, intraoperative, and postoperative considerations were extracted from the evidence. Questionnaire results showed a 60% increase in self-efficacy (P = .001), a 44% increase in knowledge (P = .001), and a 92% utilization rate (26/28 cannabis-consuming patients) of the recommendations in the clinical setting.

CONCLUSIONS

With nearly 20% of veterans indicating use of cannabis, perianesthesia nurses should be aware of the unique preoperative, intraoperative, and postoperative considerations for the cannabis-consuming patient.

NP student knowledge and perceptions of medical marijuana

OBJECTIVE

This study aimed to measure NP students' knowledge and perception of medical marijuana (MM) and determine whether they need additional education on the topic.

METHODS

A cross-sectional, descriptive study was implemented. NP students were asked to complete a survey that assessed their knowledge of MM, including adverse reactions and medical indications. Perceptions of recreational marijuana and MM were assessed through a 5-point Likert-scale questionnaire.

RESULTS

Of the 230 NP students who completed all or part of the questionnaire, 115 met inclusion criteria and were included in results. Most students (94%) felt that MM should be legalized in all US states. Likewise, 97% felt that MM education should be included in NP program curricula; however, only 30% reported receiving in-depth education on the topic. Participants were asked to identify, among 18 provided medical conditions, those which were approved indications for MM use; accurate response rate was low, though cancer, pain, cachexia, nausea/vomiting, posttraumatic stress disorder, and epilepsy were identified correctly as indications by more than half of participants. Previous MM use and religious affiliation had an impact on knowledge and perceptions of MM.

CONCLUSION

With an increasing number of states legalizing MM, NP programs must evaluate their current curricula and integrate content that addresses the gap in knowledge of MM mechanism of action, indications, and adverse reactions.

"We want what's best for patients." nurse leaders' attitudes about medical cannabis: A qualitative study

Background

The majority of states have legalized medical cannabis. Nurse leaders must be prepared for an increase in patients' use of the drug across all care settings.

Objectives

To explore nurse leaders' attitudes towards, knowledge of, and experiences with medical cannabis.

Design

: Descriptive qualitative study design.

Participants

28 nurse leaders-19 in four focus groups of 3-7 participants and another 9 in interviews.

Methods

Semi-structured, one-on-one interviews and focus groups of nurse leaders about their attitudes towards and experiences with patients' use of medical cannabis. Thematic analysis was used to identify themes and subthemes.

Results

Four major themes were identified: overwhelming support for legalized medical cannabis; importance of overcoming the stereotype of a gateway drug; problematic mismatch between federal and state cannabis policies; and nursing needs to be move involved.

Conclusions

There was strong support for legalized medical cannabis to meet patients' needs; yet, respondents reported little discussion about or education regarding medical cannabis among nurses. Inconsistent federal and state cannabis policies were viewed as especially problematic and in need of alignment.

Sources of Cannabis Information and Medical Guidance for Neurologic Use: NARCOMS Survey of People Living With Multiple Sclerosis

Background and Objectives

As cannabis products become increasingly accessible across the United States, understanding how patients obtain medical information on cannabis and view the role of their health care provider in providing information is important.

Methods

Participants with multiple sclerosis (MS) from the North American Research Committee on Multiple Sclerosis registry completed a supplemental survey on Δ⁹-tetrahydrocannabinol-containing cannabis use between March and April 2020. Participants reported dialogue with health care providers regarding cannabis use, information sources used to make product decisions, and expenditure on cannabis. Findings are reported using descriptive statistics.

Results

Overall, 3,249 participants responded (47% response rate), of whom 31% ever used cannabis and 20% currently used cannabis for MS. To determine presumed cannabis contents, respondents who had ever used cannabis (ever users) most often used dispensary-provided information (39%), word of mouth/dealer/friend (29%), and unregulated product labels (24%). For general information on cannabis for MS, ever users most often used dispensary staff (38%) and friends (32%). The primary source of medical guidance among ever users was most often “nobody or myself” (48%), followed by a dispensary professional (21%); only 12% relied on their MS physician, although 70% had discussed cannabis with their MS physician. Most current users (62%) typically sourced their cannabis from a dispensary. The most common factor in selecting a cannabis product was perceived quality and safety (70%).

Discussion

Participants most often received information on cannabis for MS from dispensaries, unregulated product labels, and friends; only a small proportion used health care providers. Evidence-based patient and physician education is needed.