Sunday 31 March 2019

"A Survey of The Attitudes, Beliefs and Knowledge About Medical Cannabis Among Primary Care Providers"

Healthcare providers play a critical role in facilitating patient access to medical cannabis. 
However, previous surveys suggest only a minority of providers believe that medical cannabis confers benefits to patients. 

Significant new knowledge about the potential benefits and harms of medical cannabis has recently emerged. Understanding current attitudes and beliefs of providers may provide 
insight into the ongoing challenges they face as states expand access to medical cannabis.
The survey
This study was funded by the Mayo Clinic and the resercers conducted an electronic survey of primary care providers in a large Minnesota-based healthcare system between January 23 and February 5, 2018 published online in January 22,2019.
They obtained information about providers characteristics,attitudes and beliefs about medical cannabis, the provider comfort level in answering patient questions about medical cannabis, and whether providers were interested in receiving additional education.

The questionnaire

The new survey tool was developed by first defining domains of interest (knowledge, attitudes, and beliefs). Questions in these domains were informed by qualitative data from patient surveys reported through the Minnesota Medical Cannabis Program. Questions were pilot tested and refined. Survey items were placed on 3- or 5-point Likert scales to garner patient agreement or perceived degree of helpfulness or frequency, based on the individual survey item. The 16-item survey was designed to address the following areas.

The results

62 providers completed the survey. 76%t of respondents were physicians and the average age was 46.3 years. 58.1% believed that "Medical cannabis was a legitimate medical therapy" and 38.7% believed that "providers should be offering to patients for managing medical conditions'.
-A majority of providers believed that "medical cannabis was helpful for treating the qualifying medical conditions of cancer, terminal illness, and intractable pain". 
-A majority of providers did not know if medical cannabis was effective for managing nearly one-half of the other state designated qualifying medical conditions.
-Few believed that medical cannabis improved quality of life domains. Over one-third of providers believed that medical cannabis interacted with medical therapies.
-One-half of providers were not ready to or did not want to answer patient questions about medical cannabis, and the majority of providers wanted to learn more about it.
-We observed that primary care healthcare providers generally believe that medical cannabis is a legitimate medical therapy and safer than illegal cannabis.

-Most providers indicated they were aware that some of their patients were using cannabis illegally to treat medical conditions, but few believed that medical cannabis improved patient quality of life domains. A significant proportion of providers endorsed that medical cannabis had potential interactions with medical therapies.

-Most providers did not endorse that they believed medical cannabis improved aspects of patient quality of life 

-They observed that over 1/3 of providers believed that medical cannabis has significant interactions with medical therapies. Providers need to be informed of potential interactions between medications they prescribe and products obtained from state dispensaries.

-We observed that 50% providers were not ready or did not want to answer patient questions about medical cannabis. (This is consistent with previous research among US residents and fellows observing that only 35.3% of respondents felt ready to answer patient questions about cannabis) 

Conclusions

Providers generally believe that medical cannabis is a legitimate medical therapy. Significant opportunities exist to:
1) close knowledge gaps for clinicians through the collection and dissemination of information about the effectiveness of medical cannabis for state qualifying conditions.
2) alleviate concerns about drug interactions by exploring opportunities for information sharing between dispensaries and traditional medical practices.
3) expand the knowledge base about how medical cannabis impacts patient

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