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Grant SJ, Gonzalez M, Heller G, Soliman S, Spiegel G, Lacey J. Knowledge and attitudes towards medicinal cannabis and complementary and integrative medicine (CIM): a survey of healthcare professionals working in a cancer hospital in Australia. Support Care Cancer 2023; 31:623. [PMID: 37819556 PMCID: PMC10567955 DOI: 10.1007/s00520-023-08080-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Abstract
PURPOSE We investigated attitudes and practices of healthcare professionals (HCPs) to medicinal cannabis (MC) and complementary and integrative medicine (CIM), including individual therapies, such as acupuncture, massage, herbs, dietary supplements, nutrition and exercise. We explored whether healthcare occupation influenced attitudes to CIM and MC; referral pathways for advice on CIM; and interest in a pharmacy service to evaluate herbs and supplements. METHODS Cross-sectional survey. All clinical staff at a comprehensive cancer hospital were invited to complete an anonymous questionnaire about CIM and MC. We used descriptive analysis to describe the respondent's knowledge and attitudes, and Fisher's exact test to test for differences by occupation, length of time at the hospital and age. RESULTS Most of the 116 HCPs respondents supported integrating CIM into cancer care (94.8%) and wanted to learn more (90%) and to understand benefits and contraindications. Most respondents believed that CIM (87.9%) could benefit patients with cancer, and MC could benefit those with advanced cancer (49-51%). Whilst just over half (52.6%) felt confident discussing CIM with patients, only 10% felt they had sufficient knowledge to discuss MC. Most felt they did not have sufficient knowledge to specifically discuss mind and body practices (63.8%) or herbs and supplements (79%). HCPs (63%) would be more inclined to allow use of herbs and supplements with cancer treatment if a pharmacy service was available to evaluate interactions. Occupation, length of time at hospital and age influenced confidence and knowledge about CIM. CONCLUSIONS The integration of evidence-based CIM and MC into cancer care is hampered by a lack of knowledge of benefits and contraindications, and gaps in education. Effective and safe integration may require targeted development of services such as pharmacy to evaluate the safety of herbs and supplements, and inclusion of cancer specialists who have received training in individual CIM therapies and MC.
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Affiliation(s)
- Suzanne J Grant
- Supportive Care and Integrative Oncology Department, Chris O'Brien Lifehouse Comprehensive Cancer Centre, Missenden Road, Camperdown, Sydney, NSW, Australia.
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
| | - Maria Gonzalez
- Supportive Care and Integrative Oncology Department, Chris O'Brien Lifehouse Comprehensive Cancer Centre, Missenden Road, Camperdown, Sydney, NSW, Australia
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Gillian Heller
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Sarah Soliman
- School of Science, Western Sydney University, Sydney, NSW, Australia
| | - Gretel Spiegel
- Supportive Care and Integrative Oncology Department, Chris O'Brien Lifehouse Comprehensive Cancer Centre, Missenden Road, Camperdown, Sydney, NSW, Australia
| | - Judith Lacey
- Supportive Care and Integrative Oncology Department, Chris O'Brien Lifehouse Comprehensive Cancer Centre, Missenden Road, Camperdown, Sydney, NSW, Australia
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia
- School of Medicine, University of Sydney, Sydney, NSW, Australia
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Pav M, Haesaert G, De Steur H. Public Knowledge, Perceptions, and Behavioral Intention Regarding Medical Cannabis in Belgium. J Psychoactive Drugs 2023:1-12. [PMID: 37155939 DOI: 10.1080/02791072.2023.2209893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Growing evidence on medical cannabis has moved its legislation forward in various countries, which has increased research on stakeholder reactions. While various studies looked at experts and users, research on public perceptions is scarce. This study aims to (1) examine the relationships between knowledge, perceptions, and behavioral intention toward medical cannabis, and (2) identify and profile key segments within the general public. An online survey was conducted among 656 respondents in Belgium. Findings showed that both subjective and objective knowledge are relatively poor, while risk/benefit perceptions and behavioral intention are much more positive. Subjective and objective knowledge as well as social trust have a positive influence on risk perceptions and a negative influence on benefit perceptions. In turn, risk and benefit perceptions are key determinants of behavioral intention, but in opposite directions. Furthermore, cluster analysis identified a cautious (23% of the sample), positive (50%), and enthusiastic cluster (27%). In terms of socio-demographic profile, older and highly educated people were significantly more represented in the latter two clusters. While our study demonstrated that cannabis is well accepted for medical purposes, research is needed to further validate the relationships between knowledge, perceptions, and (intended) behavior in different settings and policy contexts.
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Affiliation(s)
- Matthias Pav
- Division of Agri-Food Marketing and Chain Management, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
- Department of Plants and Crops, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Geert Haesaert
- Department of Plants and Crops, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Hans De Steur
- Division of Agri-Food Marketing and Chain Management, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
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Ng JY, Tahir U, Lum N. The quality of health information provided on web sites selling cannabis to consumers in Canada is poor. Harm Reduct J 2022; 19:138. [PMID: 36503517 PMCID: PMC9743698 DOI: 10.1186/s12954-022-00691-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 09/23/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Cannabis is used by millions of people for both medical and recreational purposes, and this use is even greater in jurisdictions where it is legalized, such as Canada. Online cannabis vendors have gained popularity for purchasing cannabis due to easy access and convenience to consumers. The objective of this study was to evaluate the quality of health information provided by web sites of cannabis vendors selling products to Canadian consumers and to further identify trends in the information provided. METHODS Six different searches were conducted on Google.ca, and the first 40 webpages of each search were screened for eligibility. A total of 33 unique web sites of cannabis vendors selling products to Canadian consumers were identified and included. The DISCERN instrument, which consists of 16 questions divided into three sections, was used to evaluate the quality of cannabis-related health information on these web sites. RESULTS Across the 33 web sites, the average of the summed DISCERN scores was 36.83 (SD = 9.73) out of 75, and the mean score for the overall quality of the publication (DISCERN question 16) was 2.41 (SD = 0.71) out of 5. Many of these web sites failed to discuss uncertainties in research evidence on cannabis, the impact of cannabis use on quality of life, alternatives to cannabis use, risks associated with cannabis use, and lacked references to support claims on effects and benefits of use. CONCLUSION Our findings indicate that the quality of cannabis-related health information provided by online vendors is poor. Healthcare providers should be aware that patients may use these web sites as primary sources of information and appropriately caution patients while directing them to high-quality sources. Future research should serve to replicate this study in other jurisdictions and assess the accuracy of information provided by online cannabis vendors, as this was outside the scope of the DISCERN instrument.
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Affiliation(s)
- Jeremy Y. Ng
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, Michael G. DeGroote Centre for Learning and Discovery, McMaster University, Room 2112, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Umair Tahir
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, Michael G. DeGroote Centre for Learning and Discovery, McMaster University, Room 2112, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Nicholas Lum
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, Michael G. DeGroote Centre for Learning and Discovery, McMaster University, Room 2112, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
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Jochen A, Holben D. School Nurse Perspectives of Medical Cannabis Policy in K-12 Schools: An Exploratory Descriptive Study. J Sch Nurs 2022:10598405221136288. [PMID: 36377286 DOI: 10.1177/10598405221136288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Abstract
As states legalize medical cannabis, school nurses face increased parent questions about administration at school. Although school nurses frequently collaborate on the development and implementation of medication administration policies, their perceptions of barriers to school-based medical cannabis administration are not well-documented. To explore these perceptions, we surveyed school nurses (n = 379) in sixteen states about their beliefs related to school-based medical cannabis administration policy development. Findings revealed school nurses from states completely legalizing cannabis expressed significantly fewer concerns about the safety, stigma, and federal status of medical cannabis than their peers in more restrictive states. Implications for practice include (a) education of key stakeholders, (b) collaboration with stakeholders to formulate medication administration policy; and (c) development of state-level guidance for school professionals.
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Affiliation(s)
- Alison Jochen
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Diane Holben
- Secondary Education Department, East Stroudsburg University in the Professional, East Stroudsburg University, Pennsylvania, USA
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HaGani N, Sznitman S, Dor M, Bar-Sela G, Oren D, Margolis-Dorfman L, Goor-Aryeh I, Green MS. Attitudes Toward the Use of Medical Cannabis and the Perceived Efficacy, Side-effects and Risks: A Survey of Patients, Nurses and Physicians. J Psychoactive Drugs 2022; 54:393-402. [PMID: 34893011 DOI: 10.1080/02791072.2021.2009598] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Gaps between physician and patient perceptions may lead to misunderstandings and mismanage of treatment. There are sparse data about the differences in opinions toward medical cannabis (MC) between patients and health professionals. The aim of this study was to examine the attitudes toward MC, its perceived efficacy, side effects and risk of dependency, among patients, nurses and physicians. A cross-sectional study of samples of 430 patients, 65 nurses and 65 physicians in two large medical centers in Israel. Questionnaires were administered on attitudes, perceived efficacy, side-effects and perceived risks of dependency. Compared with nurses and physicians, patients who were using MC had the most positive attitudes toward MC (p < .001). Younger age, high school education, being Jewish and ever using MC, were associated with more positive attitudes toward MC among patients (p < .001). Among nurses and physicians, having an oncology specialty predicted more positive attitudes toward MC. Physicians had a less positive attitude toward MC compared to nurses (p < .01). Our study provides evidence that physicians are less positive in their views toward MC compared to nurses and patients. More information and awareness to MC may reduce the gap in perceptions between physicians and patients.
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Affiliation(s)
- Neta HaGani
- School of Public Heath, University of Haifa, Haifa, Israel.,Rambam Medical Center, Haifa, Israel
| | | | - Michael Dor
- Department of Health Systems Management, Ariel University, Ari'el, Israel
| | - Gil Bar-Sela
- Oncology and Hematology Division, Emek Medical Center, Afula, Israel.,Faculty of Medicine, Technion, Haifa, Israel
| | - Dana Oren
- Pain Medicine Institute, Sheba Medical Center, Ramat Gan, Israel
| | | | - Itay Goor-Aryeh
- Pain Medicine Institute, Sheba Medical Center, Ramat Gan, Israel
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Zeiger JS, Silvers WS, Naimi DR, Skypala IJ, Ellis AK, Connors L, Jeimy S, Nayak AP, Bernstein JA, Zeiger RS. Impact of cannabis knowledge and attitudes on real-world practice. Ann Allergy Asthma Immunol 2022; 129:441-450. [PMID: 35472594 PMCID: PMC9869714 DOI: 10.1016/j.anai.2022.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/18/2022] [Accepted: 04/12/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Increased cannabis consumption worldwide challenges allergists because of an upsurge in cannabis allergy and need to discuss cannabis with patients. OBJECTIVE To determine the knowledge, attitudes, and practices regarding cannabis among allergists and their approach to recognizing and diagnosing suspected cannabis allergy. METHODS The International Allergist Canna Knowledge, Attitudes, and Practices Survey was completed by members from 3 International Allergy Societies. Survey questions included the following: 13 on cannabis attitudes, 7 on cannabis knowledge, and 4 on real-world allergy practices. Knowledge level was dichotomized and Statistical Package for the Social Sciences TwoStep Cluster Analysis grouped participants by attitudes. Multivariate analysis determined the relationship of knowledge and attitude to practice delivery. RESULTS Of 570 eligible surveys started, 445 (78.1%) were completed. Participants were 49.7% of female sex, 65.9% aged 24 to 56 years, approximately 70% in practice for more than or equal to 10 years, and 29.2% practicing in an area where cannabis use is illegal. Of the respondents, 43.1% reported consulting on patients with suspected cannabis allergy and 54.7% had undertaken skin prick testing, in vitro cannabis testing, or both. Statistically significant differences were found between the 3 societies for most variables analyzed. Analysis of attitudes revealed 3 clusters named Traditional, Progressive, and Unsure. Those with more progressive attitudes toward cannabis and who had more knowledge were more comfortable speaking to patients about cannabis and more often asked patients on how often and how they used cannabis (all P < .001). CONCLUSION Varying knowledge and attitudes toward cannabis affecting comfort communicating with patients about cannabis were found in members of 3 allergy societies supporting the need for more cannabis research and education.
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Affiliation(s)
| | - William S Silvers
- Canna Research Foundation, Boulder, Colorado; University of Colorado School of Medicine, Denver, Colorado
| | - David R Naimi
- Naval Hospital Camp Pendleton, Oceanside, California
| | - Isabel J Skypala
- Royal Brompton & Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Anne K Ellis
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Lori Connors
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Samira Jeimy
- Division of Clinical Immunology and Allergy, Department of Medicine, Western University, London, Ontario, Canada
| | - Ajay P Nayak
- Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jonathan A Bernstein
- University of Cincinnati College of Medicine, Bernstein Allergy Group, Cincinnati, Ohio
| | - Robert S Zeiger
- Canna Research Foundation, Boulder, Colorado; Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
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Abstract
Introduction: Many health care providers would benefit from greater knowledge and awareness of medical cannabis, even if they choose not to integrate it into their medical practice. Unfortunately, health care providers generally report low knowledge of medical cannabis and cite this lack of knowledge as a barrier to making patient recommendations. It is important to understand health care providers' medical cannabis knowledge and its correlates. However, few studies have rigorously assessed clinically relevant cannabis-related knowledge, instead typically focusing on attitudes toward cannabis and perceived knowledge. Methods: Physicians in a university-affiliated health system completed an anonymous online survey. The survey assessed participants' basic demographics and medical experience, experiences with cannabis education, beliefs about their knowledge of and competency regarding medical cannabis, and knowledge of medical cannabis in relation to the current scientific evidence. Results: The average level of medical cannabis knowledge was 58% correct, with scores ranging from 39% to 78% correct. Perceived cannabis knowledge predicted actual knowledge, and those who pursued self-initiated study or attended a lecture on medical cannabis had higher knowledge levels. Conclusion: Levels of factual knowledge about medical cannabis among physicians were moderate. Our results highlight the mismatch between physician knowledge and cannabis policy. We offer our brief, 10-min assessment as a baseline for characterizing cannabis knowledge, acknowledging that the content and interpretation may change as knowledge advances.
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Affiliation(s)
- Daniel J. Kruger
- Population Studies Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Majd A. Mokbel
- Medical School, University of Michigan, Ann Arbor, Michigan, USA
| | - Daniel J. Clauw
- Medical School, University of Michigan, Ann Arbor, Michigan, USA
| | - Kevin F. Boehnke
- Medical School, University of Michigan, Ann Arbor, Michigan, USA
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Hordowicz MJ, Jarosz J, Klimkiewicz A, Czaplińska M, Leonhard A, Wysocka M. To Treat or Not to Treat? Polish Physicians' Opinions about the Clinical Aspects of Cannabinoids-An Online Survey. J Clin Med 2022; 11:236. [PMID: 35011977 DOI: 10.3390/jcm11010236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/22/2021] [Accepted: 12/29/2021] [Indexed: 02/04/2023] Open
Abstract
Introduction: Medical cannabis’ importance in Poland increased dramatically following its legalization as the 12th country in Europe in 2017. However, no studies have been published to give insight into Polish physicians’ opinions about medical cannabis. Objectives: To investigate physician’s opinions about cannabinoids’ utility in clinical practice, concerns regarding their safety profile, and their clinical experience with cannabinoids. Methods: The survey using a self-developed tool was conducted online; participants were physicians with or without specialist training. Participation was voluntary. Physicians were recruited through personal networks, palliative care courses, and Medical Chambers. Results: From June to October 2020, we recruited 173 physicians from 15/16 voivodeships. The largest age group (43.9%; n = 76) was 30–39 year-olds. A similar proportion declared they never used cannabis and did not receive any training regarding cannabinoids (60% for both). Only 15 (8%) ever prescribed medical cannabis, although about 50% declared knowing suitable patients for such therapy, and 53.8% had at least one patient proactively asking for such treatment in the last 6 mo. The most common indication chosen was pain: chronic cancer-related (n = 128), chronic non-cancer (n = 77), and neuropathic (n = 60). Other commonly chosen conditions were alleviation of cancer treatment side-effects (n = 56) and cachexia (n = 57). The overall safety profile of THC was assessed as similar to most commonly used medications, including opioids; NSAIDs and benzodiazepines were, however, perceived as safer. Conclusions: Polish physicians favored the legalization of medical cannabis. However, it is of concern that a limited number have any experience with prescribing cannabis. The creation of clear guidelines to advise physicians in their routine practice and education about pain management and the risks related to the consumption of recreational cannabis for medical conditions are needed.
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Ng JY, Abrams A, Pathak A, Tahir U, Jomy J. What are the experiences of patients using cannabis for pain? A systematic review of qualitative studies. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2021.102098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gunning M, Rotenberg AD, Kelly LE, Crooks B, Oberoi S, Rapoport AL, Rassekh SR, Illes J. Clinician views on and ethics priorities for authorizing medical cannabis in the care of children and youth in Canada: a qualitative study. CMAJ Open 2022; 10:E196-E202. [PMID: 35292477 PMCID: PMC8929429 DOI: 10.9778/cmajo.20210239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The use of cannabis for medical purposes by pediatric patients is expanding across Canada; however, supporting evidence, federal regulations and treatment guidelines are lacking. To understand factors affecting treatment decisions in this landscape, we sought to delineate clinician perspectives, ethics priorities and values for cannabis authorization. METHODS We sampled participants purposefully through Canadian Childhood Cannabinoid Clinical Trials listservs, which include the majority of pediatric oncologists and palliative care physicians practising in Canada, among many other pediatric physicians and clinicians. Inclusion criteria were being a practising clinician in Canada, involvement in the care of children and willingness to be interviewed regardless of stance on medical cannabis. In November and December 2020, we conducted semistructured interviews focusing on principles, values and priorities, including medical, professional, regulatory, evidentiary and social considerations, for authorizing medical cannabis to children. Interviews were recorded, transcribed and analyzed by means of deductive and inductive thematic methods. RESULTS We conducted 18 interviews with a diverse group of clinicians representing a range of specialties within pediatric care, including neurology, palliative care, oncology, family medicine and pharmacology. The interviews yielded 4 themes and 12 subthemes related to a priori (medical, professional, regulatory, evidentiary and social themes) and emergent themes. The 4 themes of access, relationships and relational autonomy (autonomy within relationships), medically appropriate use and research priorities were grounded in principles of harm reduction. Participants described problematic authorization procedures that negatively affect patient use. Principles associated with relational autonomy were highlighted as a feature of open clinical communication. Benefits of appropriate medical uses weighed positively over risks, even in the context of potential effects on neurodevelopment. Participants expressed that more research is essential to align medical cannabis with biomedical standards. INTERPRETATION Clinicians reported pursuing ethical use of medical cannabis for pediatric patients and prioritizing their safety under principles of harm reduction. There is a need for evidence about neurodevelopmental risks, support for research, treatment guidelines and greater knowledge about stakeholder perspectives to alleviate burdens related to use of medical cannabis for pediatric patients in Canada.
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Affiliation(s)
- Margot Gunning
- Neuroethics Canada (Gunning, Rotenberg, Illes), Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC; Department of Pediatrics and Child Health (Kelly), University of Manitoba; George & Fay Yee Centre for Healthcare Innovation (Kelly), Winnipeg, Man.; Division of Hematology-Oncology (Crooks), Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, NS; Department of Pediatric Hematology-Oncology-BMT (Oberoi), CancerCare Manitoba, Winnipeg, Man.; Departments of Paediatrics and of Family and Community Medicine (Rapoport), Faculty of Medicine, University of Toronto; Emily's House Children's Hospice (Rapoport), Toronto, Ont.; Division of Pediatric Hematology/Oncology/BMT (Rassekh), Department of Pediatrics, University of British Columbia, Vancouver, BC
| | - Ari D Rotenberg
- Neuroethics Canada (Gunning, Rotenberg, Illes), Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC; Department of Pediatrics and Child Health (Kelly), University of Manitoba; George & Fay Yee Centre for Healthcare Innovation (Kelly), Winnipeg, Man.; Division of Hematology-Oncology (Crooks), Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, NS; Department of Pediatric Hematology-Oncology-BMT (Oberoi), CancerCare Manitoba, Winnipeg, Man.; Departments of Paediatrics and of Family and Community Medicine (Rapoport), Faculty of Medicine, University of Toronto; Emily's House Children's Hospice (Rapoport), Toronto, Ont.; Division of Pediatric Hematology/Oncology/BMT (Rassekh), Department of Pediatrics, University of British Columbia, Vancouver, BC
| | - Lauren E Kelly
- Neuroethics Canada (Gunning, Rotenberg, Illes), Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC; Department of Pediatrics and Child Health (Kelly), University of Manitoba; George & Fay Yee Centre for Healthcare Innovation (Kelly), Winnipeg, Man.; Division of Hematology-Oncology (Crooks), Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, NS; Department of Pediatric Hematology-Oncology-BMT (Oberoi), CancerCare Manitoba, Winnipeg, Man.; Departments of Paediatrics and of Family and Community Medicine (Rapoport), Faculty of Medicine, University of Toronto; Emily's House Children's Hospice (Rapoport), Toronto, Ont.; Division of Pediatric Hematology/Oncology/BMT (Rassekh), Department of Pediatrics, University of British Columbia, Vancouver, BC
| | - Bruce Crooks
- Neuroethics Canada (Gunning, Rotenberg, Illes), Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC; Department of Pediatrics and Child Health (Kelly), University of Manitoba; George & Fay Yee Centre for Healthcare Innovation (Kelly), Winnipeg, Man.; Division of Hematology-Oncology (Crooks), Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, NS; Department of Pediatric Hematology-Oncology-BMT (Oberoi), CancerCare Manitoba, Winnipeg, Man.; Departments of Paediatrics and of Family and Community Medicine (Rapoport), Faculty of Medicine, University of Toronto; Emily's House Children's Hospice (Rapoport), Toronto, Ont.; Division of Pediatric Hematology/Oncology/BMT (Rassekh), Department of Pediatrics, University of British Columbia, Vancouver, BC
| | - Sapna Oberoi
- Neuroethics Canada (Gunning, Rotenberg, Illes), Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC; Department of Pediatrics and Child Health (Kelly), University of Manitoba; George & Fay Yee Centre for Healthcare Innovation (Kelly), Winnipeg, Man.; Division of Hematology-Oncology (Crooks), Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, NS; Department of Pediatric Hematology-Oncology-BMT (Oberoi), CancerCare Manitoba, Winnipeg, Man.; Departments of Paediatrics and of Family and Community Medicine (Rapoport), Faculty of Medicine, University of Toronto; Emily's House Children's Hospice (Rapoport), Toronto, Ont.; Division of Pediatric Hematology/Oncology/BMT (Rassekh), Department of Pediatrics, University of British Columbia, Vancouver, BC
| | - Adam L Rapoport
- Neuroethics Canada (Gunning, Rotenberg, Illes), Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC; Department of Pediatrics and Child Health (Kelly), University of Manitoba; George & Fay Yee Centre for Healthcare Innovation (Kelly), Winnipeg, Man.; Division of Hematology-Oncology (Crooks), Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, NS; Department of Pediatric Hematology-Oncology-BMT (Oberoi), CancerCare Manitoba, Winnipeg, Man.; Departments of Paediatrics and of Family and Community Medicine (Rapoport), Faculty of Medicine, University of Toronto; Emily's House Children's Hospice (Rapoport), Toronto, Ont.; Division of Pediatric Hematology/Oncology/BMT (Rassekh), Department of Pediatrics, University of British Columbia, Vancouver, BC
| | - S Rod Rassekh
- Neuroethics Canada (Gunning, Rotenberg, Illes), Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC; Department of Pediatrics and Child Health (Kelly), University of Manitoba; George & Fay Yee Centre for Healthcare Innovation (Kelly), Winnipeg, Man.; Division of Hematology-Oncology (Crooks), Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, NS; Department of Pediatric Hematology-Oncology-BMT (Oberoi), CancerCare Manitoba, Winnipeg, Man.; Departments of Paediatrics and of Family and Community Medicine (Rapoport), Faculty of Medicine, University of Toronto; Emily's House Children's Hospice (Rapoport), Toronto, Ont.; Division of Pediatric Hematology/Oncology/BMT (Rassekh), Department of Pediatrics, University of British Columbia, Vancouver, BC
| | - Judy Illes
- Neuroethics Canada (Gunning, Rotenberg, Illes), Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC; Department of Pediatrics and Child Health (Kelly), University of Manitoba; George & Fay Yee Centre for Healthcare Innovation (Kelly), Winnipeg, Man.; Division of Hematology-Oncology (Crooks), Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, NS; Department of Pediatric Hematology-Oncology-BMT (Oberoi), CancerCare Manitoba, Winnipeg, Man.; Departments of Paediatrics and of Family and Community Medicine (Rapoport), Faculty of Medicine, University of Toronto; Emily's House Children's Hospice (Rapoport), Toronto, Ont.; Division of Pediatric Hematology/Oncology/BMT (Rassekh), Department of Pediatrics, University of British Columbia, Vancouver, BC
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Weisman JM, Rodríguez M. A systematic review of medical students' and professionals' attitudes and knowledge regarding medical cannabis. J Cannabis Res 2021; 3:47. [PMID: 34641976 DOI: 10.1186/s42238-021-00100-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 08/30/2021] [Indexed: 12/17/2022] Open
Abstract
Background Recently, the renewed global interest in cannabis’ therapeutic properties has resulted in shifting attitudes and legislative policies worldwide. The aim of this systematic review is to explore the existing literature on medical professionals’ and students’ attitudes and knowledge regarding medicinal cannabis (MC) to assess any relevant and significant trends. Methods This systematic review was conducted in accordance with PRISMA guidelines. Using PubMed and Google Scholar, a literature search was performed to identify studies pertaining to healthcare professionals’ and medical students’ knowledge and attitudes regarding MC. There were no search limits on the year of publication; however, studies without primary data (e.g., abstracts, systematic reviews, meta-analyses) and non-English language papers were excluded. Studies were coded according to the following research questions: (1) Do respondents believe that cannabis should be legalized (for medicinal and/or recreational purposes)? (2) Are respondents confident in their level of knowledge regarding cannabis’ clinical applications? (3) Are respondents convinced of cannabis’ therapeutic potential? 4) What current gaps in knowledge exist, and how can the medical community become better informed about cannabis’ therapeutic uses? and (5) Are there significant differences between the knowledge and opinions of healthcare students versus healthcare professionals with respect to any of the aforementioned queries? Chi-square tests were used to assess differences between medical students and medical professionals, and Pearson’s bivariate correlations were used to analyze associations between survey responses and year of publication—as a proxy measurement to assess change over time. Results Out of the 741 items retrieved, 40 studies published between 1971 and 2019 were included in the final analyses. In an evaluation of 21 qualified studies (8016 respondents), 49.9% of all respondents favored legalization (SD = 25.7, range: 16–97%). A correlational analysis between the percentage of survey respondents who support MC legalization and year of publication suggests that both medical students’ and professionals’ support for MC legalization has increased from 1991 to 2019 (r(19) = .44, p = .045). Moreover, medical professionals favor the legalization of MC at a significantly higher rate than students (52% vs. 42%, respectively; χ2 (1, N = 9019) = 50.72 p < .001). Also, respondents consistently report a strong desire for more education about MC and a substantial concern regarding MC’s potential to cause dependence and addiction. Pearson’s correlations between year of publication and survey responses for both of these queried variables suggest minimal changes within the last decade (2011–2019 for addiction and dependence, 2012-2019 for additional education; r(13) = − .10, p = .713 and r(12) = − .12, p = .678, respectively). Conclusion The finding that both medical students’ and professionals’ acceptance of MC has significantly increased in recent decades—in conjunction with their consistent, strong desire for more educational material—suggests that the medical community should prioritize the development of MC educational programs. MC is far more likely to succeed as a safe and viable therapy if the medical professionals who administer it are well-trained and confident regarding its clinical effects. Limitations include a lack of covariate-based analyses and the exclusion of studies published after the literature search was performed (June 2019). Future research should analyze studies published post-2019 to draw temporal comparisons and should investigate the effect of numerous covariates (e.g., gender, religiosity, prior cannabis use) as newer studies gather data on these factors [PROSPERO Registration: CRD42020204382].
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Hordowicz M, Jarosz J, Czaplińska M, Leonhard A, Klimkiewicz A. Polish Physicians' Perspectives on Medical Cannabis Policy and Educational Needs: Results of An Online Survey. J Clin Med 2021; 10:jcm10194545. [PMID: 34640561 PMCID: PMC8509273 DOI: 10.3390/jcm10194545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/15/2021] [Accepted: 09/27/2021] [Indexed: 11/18/2022] Open
Abstract
(1) Background: In November 2017, medical cannabis was legalized in Poland. Until now, there have been no studies conducted to examine the perspectives of Polish physicians about their preferences regarding medical cannabis legal status and educational needs. (2) Methods: The survey was a self-developed online questionnaire with 57 participants. Participation was voluntary. The link was shared through a personal network of medical doctors, regional medical chambers, and with doctors attending palliative care courses organized by our research group. Results: Between June and October 2020, 173 HCPs from Poland completed the survey. More than half of the study participants never received any education on medical cannabis (60.1%); 71.1% declared their knowledge was insufficient to counsel patients about medical cannabis use. The majority claimed that they would like to be able to answer patient questions (92.4%); 93.1% declared a need to create clear guidelines for using cannabinoids in clinical practice. Furthermore, 71.7% believed that medicines containing cannabinoids and 52.0% that herbal cannabis should be reimbursed (3). Conclusion: Most medical doctors do not feel prepared for patient counseling. They could benefit from targeted educational interventions. We have also identified physicians’ preferences that might inspire the stakeholders involved who are critical for shaping policies regarding cannabis-based therapeutics.
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Affiliation(s)
- Martyna Hordowicz
- Hospice of St. Christopher in Warsaw, 02-781 Warsaw, Poland; (M.C.); (A.L.)
- Polish Society of Medical Cannabis and Cannabinoids, 02-781 Warsaw, Poland; (J.J.); (A.K.)
- Correspondence:
| | - Jerzy Jarosz
- Polish Society of Medical Cannabis and Cannabinoids, 02-781 Warsaw, Poland; (J.J.); (A.K.)
| | - Małgorzata Czaplińska
- Hospice of St. Christopher in Warsaw, 02-781 Warsaw, Poland; (M.C.); (A.L.)
- Polish Society of Medical Cannabis and Cannabinoids, 02-781 Warsaw, Poland; (J.J.); (A.K.)
- Medical Faculty, Medical University of Warsaw, 02-781 Warsaw, Poland
| | - Agnieszka Leonhard
- Hospice of St. Christopher in Warsaw, 02-781 Warsaw, Poland; (M.C.); (A.L.)
- Polish Society of Medical Cannabis and Cannabinoids, 02-781 Warsaw, Poland; (J.J.); (A.K.)
| | - Anna Klimkiewicz
- Polish Society of Medical Cannabis and Cannabinoids, 02-781 Warsaw, Poland; (J.J.); (A.K.)
- Medical Faculty, Medical University of Warsaw, 02-781 Warsaw, Poland
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