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Russo E, Agredano PM, Flachenecker P, Lawthom C, Munro D, Hindocha C, Bagul M, Trinka E. The attitudes, knowledge and confidence of healthcare professionals about cannabis-based products. J Cannabis Res 2024; 6:32. [PMID: 39049083 PMCID: PMC11267914 DOI: 10.1186/s42238-024-00242-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 07/07/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Use of cannabis-based products is becoming more frequent, and it is important that healthcare professionals are informed and confident about them when making evidence-based decisions about their use. This study aimed to gain an international perspective on the attitudes, knowledge, and confidence of healthcare professionals about cannabis-based products. METHODS An online questionnaire regarding these products was completed by 1580 healthcare professionals (neurologists, psychiatrists, general practitioners, pharmacists and nurses) from 16 countries across Asia, Europe, Oceania, South America, and the Middle East. RESULTS Respondents expressed a high level of interest in cannabis-based products (median score 9 out of 10) and reported that they felt knowledgeable about them (median score 6 out of 7). They reported a high level of confidence when providing patients with information on cannabis-based products, returning median scores of 6 and 5 out of 7 for their legality and regulations, and their benefits and risks, respectively. Despite this, healthcare professionals sought further information on cannabis-based products across areas including legality, neurobiology, and scientific evidence. Finally, 59% (n = 930) of respondents considered robust clinical trial evidence as the most important factor to ensure patient safety in the context of these products. Few nominally significant differences emerged between healthcare professionals from different specialities or regions. CONCLUSION In conclusion, this large survey of attitudes held by healthcare professionals towards cannabis-based products revealed a high level of interest and a demand for more information. Limitations of this study include potential sample bias and limited external validity.
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Affiliation(s)
- Emilio Russo
- Science of Health Department, Magna Grecia University, Catanzaro, Italy.
| | | | | | | | | | - Chandni Hindocha
- GW Pharmaceuticals (Part of Jazz Pharmaceuticals), Cambridge, UK
| | - Makarand Bagul
- GW Pharmaceuticals (Part of Jazz Pharmaceuticals), Cambridge, UK
| | - Eugen Trinka
- Department of Neurology, Christian-Doppler University Hospital, Paracelsus Medical University, Centre for Cognitive Neuroscience Salzburg, Member of the European Reference Network, EpiCARE, Salzburg, Austria
- Neuroscience Institute, Christian-Doppler Medical Centre, Paracelsus Medical University, Centre for Cognitive Neuroscience Salzburg, Salzburg, Austria
- Karl Landsteiner Institute of Neurorehabilitation and Space Neurology, Salzburg, Austria
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Zeiger JS, Silvers WS, Zeiger RS. Comparison of cannabis knowledge, attitudes, and practice between allergists and patients with allergies and asthma. Ann Allergy Asthma Immunol 2024:S1081-1206(24)00347-8. [PMID: 38879163 DOI: 10.1016/j.anai.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024]
Affiliation(s)
| | - William S Silvers
- Canna Research Foundation, Boulder, Colorado; Department of Medicine, University of Colorado School of Medicine, Denver, Colorado
| | - Robert S Zeiger
- Canna Research Foundation, Boulder, Colorado; Department of Clinical Science, Kaiser Permanente Tyson J School of Medicine, Pasadena, California
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Bobitt J, Berryman K, Weaver FM. VA Providers' Perceptions of Cannabis Use Policies in a Legalized and Nonlegalized State. Cannabis Cannabinoid Res 2024. [PMID: 38597903 DOI: 10.1089/can.2023.0276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Background: Providers in the Department of Veterans Affairs (VA) system are caught between two opposing sets of laws regarding cannabis and cannabidiol (CBD) use by their patients. As VA is a federal agency, it must abide by federal regulations, including that the Food and Drug Administration classifies cannabis as a Schedule 1 drug and therefore cannot recommend or help Veterans obtain it. Meanwhile, 38 states have passed legislation, legalizing medical use of cannabis. Objective: The goal of this project is to examine how VA providers understand state and federal laws, and VA policies about cannabis and CBD use, and to learn more about providers' experiences with patients who use cannabis and CBD within a legalized and nonlegalized state. Materials and Methods: We identified 432 health care providers from two VA facilities in northern Illinois (IL) where medical and recreational cannabis is legal, and two VA facilities in southern Wisconsin (WI) where medical and recreational cannabis is illegal. Participants were invited via e-mail to complete an anonymous online survey, including 31 closed- and open-ended questions about knowledge of state and federal laws and VA policies regarding cannabis and CBD oil, thoughts about the value of cannabis or CBD for treating medical conditions, and behaviors regarding cannabis use by their patients. Results: We received 50 responses (IL N=20, WI N=30). Providers in both states were knowledgeable about cannabis laws in their state but unsure whether they could recommend cannabis. There were more providers who were unclear if they could have a conversation about cannabis with their VA patients in WI compared with IL. Providers were more likely to agree than disagree that cannabis can be beneficial, χ2 (1, 49)=4.74, p=0.030. Providers in both states (81.6%) believe cannabis use is acceptable for end-of-life care, but responses varied for other conditions and symptoms. Discussion: Findings suggest that VA providers could use more guidance on what is allowable within their VA facilities and how state laws affect their practice. Education about safety related to cannabis and other drug interactions would be helpful. There is limited information about possible interactions, warranting future research.
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Affiliation(s)
- Julie Bobitt
- Department of Medicine, Center for Dissemination and Implementation Science, College of Medicine, University of Illinois Chicago, Chicago, Illinois, USA
- Center of Innovation for Complex Chronic Healthcare, Edward J. Hines, Jr. Veterans Affairs Hospital, Hines, Illinois, USA
| | - Kelsey Berryman
- Center of Innovation for Complex Chronic Healthcare, Edward J. Hines, Jr. Veterans Affairs Hospital, Hines, Illinois, USA
- Department of Public Health, Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, Illinois, USA
| | - Frances M Weaver
- Center of Innovation for Complex Chronic Healthcare, Edward J. Hines, Jr. Veterans Affairs Hospital, Hines, Illinois, USA
- Department of Public Health, Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, Illinois, USA
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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 2024; 56:187-198. [PMID: 37155939 DOI: 10.1080/02791072.2023.2209893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 03/02/2023] [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 benefit perceptions and a negative influence on risk 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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Schuhmacher S, Gaid D, Bishop LD, Fleming L, Donnan J. Planting the seeds for success: A qualitative study exploring primary healthcare providers' perceptions about medical cannabis. PLoS One 2024; 19:e0295858. [PMID: 38451984 PMCID: PMC10919677 DOI: 10.1371/journal.pone.0295858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/30/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND In Canada, cannabis legalization altered the way that the public can access cannabis for medical purposes. However, Canadians still struggle with finding healthcare professionals (HCPs) who are involved in medical cannabis counselling and authorization. This raises questions about the barriers that are causing this breakdown in care. Our study explored the perceptions of primary care providers regarding cannabis in their practice. METHODS Semi-structured interviews were conducted by Zoom with HCPs in Newfoundland and Labrador (NL) to discuss their experiences with medical and non-medical cannabis in practice. Family physicians and nurse practitioners who were practicing in primary care in NL were included. The interview guide and coding template were developed using the Theoretical Domains Framework (TDF). A thematic analysis across the TDF was then conducted. RESULTS Twelve participants with diverse demographic backgrounds and experience levels were interviewed. Five main themes emerged including, knowledge acquisition, internal influences, patient influences, external HCP influences, and systemic influences. The TDF domain resulting in the greatest representation of codes was environmental context and resources. INTERPRETATION The findings suggested that HCPs have significant knowledge gaps in authorizing medical cannabis, which limited their practice competence and confidence in this area. Referring patients to cannabis clinics, while enforcing harm-reduction strategies, was an interim option for patients to access cannabis for medical purposes. However, developing practice guidelines and educational resources were suggested as prominent facilitators to promote medical cannabis authorization within the healthcare system.
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Affiliation(s)
- Sandi Schuhmacher
- School of Pharmacy, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - Dina Gaid
- School of Pharmacy, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - Lisa D. Bishop
- School of Pharmacy, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - Laura Fleming
- School of Pharmacy, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - Jennifer Donnan
- School of Pharmacy, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
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Denneler T, Mahling M, Hermann S, Stengel A, Zipfel S, Herrmann-Werner A, Festl-Wietek T. Medical students' attitudes and perceived competence regarding medical cannabis and its suggestibility. BMC MEDICAL EDUCATION 2024; 24:149. [PMID: 38360743 PMCID: PMC10867999 DOI: 10.1186/s12909-024-05089-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/23/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION The global trend of legalizing medical cannabis (MC) is on the rise. In Germany, physicians have prescribed MC at the expense of health insurers since 2017. However, the teaching on MC has been scant in medical training. This study investigates medical students' attitudes and perceived competence regarding MC and evaluates how varying materials (videos/articles) impact their opinions. METHODS Fourth-year medical students were invited to participate in the cross-sectional study. During an online session, students viewed a video featuring a patient with somatoform pain discussing her medical history, plus one of four randomly assigned MC-related materials (each an article and a video depicting a positive or negative perspective on MC). Students' opinions were measured at the beginning [T0] and the end of the course [T1] using a standardized questionnaire with a five-point Likert scale. We assessed the influence of the material on the students' opinions using paired-sample t-tests. One-way analysis of variance and Tukey post-hoc tests were conducted to compare the four groups. Pearson correlations assessed correlations. RESULTS 150 students participated in the course, the response rate being 75.3% [T0] and 72.7% [T1]. At T0, students felt a little competent regarding MC therapy (M = 1.80 ± 0.82). At T1, students in groups 1 (positive video) and 3 (positive article) rated themselves as more capable in managing MC therapy [Formula: see text], and students in groups 3 (positive article) and 4 (negative article) felt more skilled in treating patients with chronic pain [Formula: see text]. Compared to the other groups, group 2 students (negative video) felt significantly less competent. They perceived cannabis as addictive, hazardous and unsuitable for medical prescription. DISCUSSION This study showed that medical students lack knowledge and perceived competence in MC therapy. Material influences their opinions in different ways, and they seek more training on MC. This underlines that integrating MC education into medical curricula is crucial to address this knowledge gap.
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Affiliation(s)
- Tatjana Denneler
- Deanery of Students' Affairs, Faculty of Medicine, University of Tuebingen, Tuebingen, Germany
| | - Moritz Mahling
- TIME- Tuebingen Institute for Medical Education, University of Tuebingen, Tuebingen, Germany
- Department of Diabetology, Endocrinology, Nephrology, Section of Nephrology and Hypertension, University Hospital Tuebingen, Tuebingen, Germany
| | - Sabine Hermann
- University Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Tuebingen, Tuebingen, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapie, University Hospital of Tuebingen, Tuebingen, Germany
- German Center for Mental Health (DZPG), site Tuebingen, Tuebingen, Germany
- Center for Internal Medicine and Dermatology, Deparment of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapie, University Hospital of Tuebingen, Tuebingen, Germany
| | - Anne Herrmann-Werner
- TIME- Tuebingen Institute for Medical Education, University of Tuebingen, Tuebingen, Germany
- Department of Psychosomatic Medicine and Psychotherapie, University Hospital of Tuebingen, Tuebingen, Germany
| | - Teresa Festl-Wietek
- TIME- Tuebingen Institute for Medical Education, University of Tuebingen, Tuebingen, Germany.
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Fehr F, Lo LA, Nelson C, Nanson K, Diehl L, Nielson K, Reddon H, Walsh Z. Stigma-related barriers to medical cannabis as harm reduction for substance use disorder: Obstacles and opportunities for improvement. Int J Ment Health Nurs 2024; 33:195-201. [PMID: 37767954 DOI: 10.1111/inm.13231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023]
Abstract
Emerging evidence on substituting cannabis for more harmful drugs has led to cannabis becoming a novel harm-reduction strategy for combating the current drug poisoning crisis. However, the authorization of medical cannabis as part of a harm-reduction approach and recovery strategy has significant implementation barriers rooted in longstanding stigma towards cannabis. Through a multi-discipline collaboration of Canadian clinicians and academic researchers, we highlighted stigma barriers and opportunities to address these barriers to elicit improved delivery of medical cannabis as a harm-reduction therapy within existing therapeutic frameworks. Evidence from existing literature and real-world experiences converged on three key themes related to stigma barriers: (1) Lack of medical cannabis education within the healthcare community, (2) lack of consensus and coordination among harm-reduction services and (3) access to medical cannabis. We highlight potential solutions to these issues, including improved healthcare education, better coordination between care teams and suggestions for improving access. Through this discussion, we hope to contribute to reducing the stigma around using medical cannabis as a harm-reduction strategy for individuals with a substance use disorder and consider new perspectives in policy development surrounding recovery services.
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Affiliation(s)
- Florriann Fehr
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Lindsay A Lo
- Department of Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Chris Nelson
- Department of Psychology, University of British Columbia, Kelowna, British Columbia, Canada
| | - Kate Nanson
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Lauren Diehl
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Karl Nielson
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Hudson Reddon
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada
| | - Zach Walsh
- Department of Psychology, University of British Columbia, Kelowna, British Columbia, Canada
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Batinic A, Curkovic A, Bukic J, Žuntar I, Kuret S, Mimica B, Kalajzic N, Dujic G, Glavaš-Obrovac L, Soldo A, Včeva A, Dujic Z, Sutlovic D. Knowledge and Attitudes of Cannabidiol in Croatia among Students, Physicians, and Pharmacists. PHARMACY 2023; 12:2. [PMID: 38251396 PMCID: PMC10801513 DOI: 10.3390/pharmacy12010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/12/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Due to cannabidiol's health benefits and absence of serious side effects, its use is constantly growing. This is a survey-based cross-sectional study that was conducted to determine Croatian pharmacists', physicians', and students' knowledge and attitudes about cannabidiol (CBD). Two questionnaires were created, one for students and the other for physicians and pharmacists. Our participants (in total 874: 473 students and 401 physicians and pharmacists) generally had positive attitudes towards CBD therapy as approximately 60% of them believe that CBD treatment is generally efficacious. Participants had positive attitudes toward the therapeutic value of CBD, especially pharmacists and pharmacy students (63.8% and 72.2%, respectively). Pharmacists were significantly more convinced that CBD could reduce the use of opioids prescribed for chronic pain (p < 0.05). Only 17.5% of students had read scientific papers about CBD, compared to a significantly higher percentage of physicians and pharmacists (43.0% and 47.8%, respectively) (p < 0.05). This study revealed a gap in knowledge regarding CBD, since 89.3% of pharmacists and physicians, as well as 84.8% of students, believe they need more education about CBD. We conclude that it is important to improve the educational curricula so that medical professionals can recommend CBD use to their patients when needed.
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Affiliation(s)
- Ana Batinic
- Pharmacy of Split-Dalmatia County, 21000 Split, Croatia
| | - Ana Curkovic
- Department of Health Studies, University of Split, 21000 Split, Croatia; (A.C.); (S.K.); (N.K.); (D.S.)
| | - Josipa Bukic
- Department of Pharmacy, University of Split School of Medicine, 21000 Split, Croatia;
| | - Irena Žuntar
- Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia;
| | - Sendi Kuret
- Department of Health Studies, University of Split, 21000 Split, Croatia; (A.C.); (S.K.); (N.K.); (D.S.)
| | - Bianka Mimica
- School of Medicine, University of Split School of Medicine, 21000 Split, Croatia
| | - Nina Kalajzic
- Department of Health Studies, University of Split, 21000 Split, Croatia; (A.C.); (S.K.); (N.K.); (D.S.)
| | - Goran Dujic
- Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia;
| | - Ljubica Glavaš-Obrovac
- Department of Medicinal Chemistry, Biochemistry and Clinical Chemistry, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Ana Soldo
- Croatian Chamber for Pharmacists, 10000 Zagreb, Croatia;
| | - Andrijana Včeva
- Department of Otorhinolaryngology and Maxillofacial Surgery, Medical Faculty, University of Osijek, J. Huttlera 4, 31000 Osijek, Croatia;
- Department of Otorhinolaryngology and Head and Neck Surgery, Clinical Hospital Centre Osijek, J. Huttlera 4, 31000 Osijek, Croatia
| | - Zeljko Dujic
- Department of Integrative Physiology, School of Medicine, University of Split, 21000 Split, Croatia;
| | - Davorka Sutlovic
- Department of Health Studies, University of Split, 21000 Split, Croatia; (A.C.); (S.K.); (N.K.); (D.S.)
- Department of Toxicology and Pharmacogenetics, School of Medicine, University of Split, 21000 Split, Croatia
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Ross B, Trojian T, Cushman DM. Physician Perceptions of Cannabidiol (CBD) and Cannabis in Sports Medicine and Performance. TRANSLATIONAL SPORTS MEDICINE 2023; 2023:8824466. [PMID: 38654915 PMCID: PMC11022760 DOI: 10.1155/2023/8824466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 11/07/2023] [Accepted: 11/24/2023] [Indexed: 04/26/2024]
Abstract
Objectives There is growing evidence regarding cannabinoid use in sports medicine and performance, especially cannabidiol (CBD). This study aims to determine if sports medicine physicians are recommending cannabinoids for therapeutic purposes, as well as analyze perceptions of cannabinoids within sports medicine and performance. Methods Physician members of the American Medical Society for Sports Medicine (AMSSM) completed an anonymous survey on demographics, CBD and Cannabis recommendations, as well as attitudes toward cannabinoid products within sports medicine. Factors associated with CBD and cannabis recommendations as well as perceptual differences were found using multivariate regression modelling. Results Responses from 333 physicians were recorded. The following groups were less likely to agree with allowing cannabis for recreational purposes: female gender (coeff. = 0.79 (0.33-1.25), p=0.001), increasing age (coeff. = 0.04 (0.02, 0.07), p < 0.001), and rural respondents (compared to baseline urban, coeff. = 1.16 (0.36, 1.95), p=0.004). Similarly, these three factors were associated with a higher likelihood of disagreeing with WADA removing cannabis from the prohibited substance list and with the NCAA allowing CBD use by collegiate athletes (p ≤ 0.045). CBD was less likely to be recommended by pediatricians, rural physicians, and academic physicians (p ≤ 0.030). Male physicians and younger physicians were less likely to identify cannabis as performance-enhancing (p ≤ 0.042). Conclusions Sports medicine physicians have varying views on cannabinoids. While sports medicine physicians generally have favorable attitudes toward CBD and cannabis, these perceptions appear to be significantly affected by age, practice type, and gender.
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Affiliation(s)
- Brendon Ross
- University of Chicago, Department of Orthopedic Surgery & Rehabilitation Medicine, Chicago, IL, USA
| | | | - Daniel M. Cushman
- University of Utah, Department of Physical Medicine & Rehabilitation and Department of Orthopaedics, Salt Lake City, UT, USA
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Farmer SE, Arnold JA, Hughes PJ, Pan K, Gorman GS. A Continuing Pharmacy Education (CPE) Program Assessing Cannabidiol (CBD) Knowledge and Confidence Among Practicing Pharmacists. J Pharm Pract 2023:8971900231213938. [PMID: 37933430 DOI: 10.1177/08971900231213938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Background: Increased patient utilization of cannabidiol (CBD) leads to potential drug interactions with various medications and questions posed to pharmacists. Objective: To quantify the knowledge gap of pharmacists on CBD and CBD-containing products and assess the degree a continuing pharmacy education (CPE) program alters pharmacist confidence and competency on CBD knowledge. Methods: A 1-h CPE activity was offered as a home study from May 9, 2022, through September 30, 2022. Subjects were practicing pharmacy preceptors in Alabama who completed the pre-survey and post-survey for inclusion in matched-pair analyses. The primary outcome measure was participant score improvement between the pre-post surveys. Secondary measures involved pre-post comparisons on self-rated Likert questions concerning participant confidence in counseling, answering drug information questions, and ensuring patient safety regarding CBD. Results: A total of 124 participants completed the course. After matched pairing, 64 and 56 individuals were included in the knowledge-based and confidence ranking analyses, respectively. Participant scoring improved on the knowledge-based questions between the pre-post surveys (50.0% vs 87.8%, P < .001). There was a significant confidence improvement of participants from baseline on counseling patients about prescription or over-the-counter CBD products, answering questions from other healthcare professionals about these products, and ensuring patient safety while using these products (Average 5-level Likert scale increases of 1.75, 1.73, 1.70, respectively; all P < .001). Conclusion: Implementation of a CPE program improved practicing pharmacists' knowledge on information about CBD, which lead to increased competency on counseling patients, answering drug information questions, and promoting patient safety.
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Affiliation(s)
- Sarah E Farmer
- McWhorter School of Pharmacy, Samford University, Birmingham, AL, USA
| | - John A Arnold
- McWhorter School of Pharmacy, Samford University, Birmingham, AL, USA
| | - Peter J Hughes
- McWhorter School of Pharmacy, Samford University, Birmingham, AL, USA
| | - Kevin Pan
- Brock School of Business, Samford University, Birmingham, AL, USA
| | - Greg S Gorman
- McWhorter School of Pharmacy, Samford University, Birmingham, AL, USA
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Sokratous S, Mpouzika M, Kaikoushi K, Alexandrou G, Karanikola M. Attitudes, beliefs, and knowledge regarding medical cannabis among healthcare students in the Republic of Cyprus: a cross-sectional descriptive correlational study. Front Psychiatry 2023; 14:1196915. [PMID: 37520218 PMCID: PMC10375702 DOI: 10.3389/fpsyt.2023.1196915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/21/2023] [Indexed: 08/01/2023] Open
Abstract
Background Although international research-based literature from the last 2 decades seems to favor the use of medical cannabis (MC), there is a lack of evidence concerning healthcare students' education on MC in the Republic of Cyprus and across the world. Therefore, this study explores healthcare students' attitudes, beliefs, and knowledge regarding the use of MC. We paid special attention to differences across specific sociodemographic (gender, age, and religion status) and educational (level of study and study field) characteristics. Methods A descriptive cross-sectional study was conducted between November 2019 and March 2020. All active undergraduate and postgraduate healthcare students (nurses, physiotherapists, speech therapists, pharmacists, and occupational therapists; N = 900) studying in public and private universities in the Republic of Cyprus were eligible to participate (final sample: N = 819, response rate = 91%). To collect data on the attitudes, beliefs and knowledge of the participants, we used the Medical Cannabis Questionnaire (MCQ). To analyze the data, we employed the Pearson's chi-square test for group differences, in addition to assessing the descriptive and inferential statistics. Results Approximately 82.2% believed that MC education should be integrated into the clinical practice requirements. Statistically significant differences were observed between genders in terms of beliefs/risk associated with the use of MC, with males being more likely to believe that there are significant mental-health benefits associated with using ΜC compared to females (84.9% vs. 76.2%, p<0.05). Females were more likely than males to believe that using MC poses serious physical (76.8% vs. 60.6%, p<0.001) and mental-health (77.9% vs. 66%, p<0.001) risks. Moreover, participants who received formal education about MC during their study/training were more prepared to answer patient/client questions about ΜC (p < 0.001). In addition, participants who received formal education had more frequently friends (p < 0.001) or family members who used MC (p < 0.005). Conclusion This study provides useful information for curriculum development, educational changes, and policy decisions related to cannabis use for medical purposes in the Republic of Cyprus. The results showed that the majority of the healthcare students who participated in the study favored MC use. However, the participants reported a lack of knowledge and recommended additional evidence-based research and education to enhance their knowledge about MC use. Therefore, we recommend the implementation of formal education on MC among healthcare students in the Republic of Cyprus during their study and clinical training. Furthermore, it is important to include MC-related theoretical and clinical/laboratory courses during studies and clinical practice.
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Affiliation(s)
- Sokratis Sokratous
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Meropi Mpouzika
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | | | | | - Maria Karanikola
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
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Alsolamy RM, Almaddah T, Aljabri A, Maaddawi HA, Alzahrani F, Gashlan M. Knowledge and Attitude of Saudi Physicians Toward Cannabidiol for Pediatric Epilepsy: A Cross-Sectional Study. Cureus 2023; 15:e36622. [PMID: 37155439 PMCID: PMC10122783 DOI: 10.7759/cureus.36622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 05/10/2023] Open
Abstract
Background Epilepsy is one of the most common neurological diseases. Various institutions have shown an interest to investigate the role of cannabidiol (CBD) in treating pediatric epilepsy. CBD is a chemical extracted from the cannabis plant and lacks the euphoria-inducing characteristic. Despite the FDA approval, the physicians' attitude toward CBD is controversial. Therefore, we aim to measure physicians' knowledge and acceptance of the use of CBD in managing epilepsy patients in Saudi Arabia. Objectives The aim of this study is to measure the knowledge and attitude of physicians regarding CBD use in pediatric epilepsy. Methods In this cross-sectional study, a validated electronic survey was distributed in the period between September 2021 and October 2021 among pediatricians and neurologists at King Abdulaziz Medical City. The survey consisted of four sections: demographics, the perceived knowledge regarding CBD, the knowledge test, and the attitudes toward CBD. Three-scoring systems were established to assess these sections. Results A total of 94 participants were included in this study; 50% of them were males, 81.9% of the participants were in the pediatric field, 13.8% were in the field of neurology, and 4.3% were pediatric neurologists. As for the professional tenure, approximately half of the participants were residents/trainees. Overall, respondents tend to have low perceived knowledge (94.7%) and attitude (93.6%) regarding CBD use. The perceived knowledge and attitude levels were found to be significantly associated with specialty (p < 0.001 and p = 0.001, respectively). Pediatric neurologists had a significantly higher self-assessment score, while pediatricians had the lowest attitude level (p < 0.05). For the knowledge test, surprisingly only one respondent answered all questions correctly, and age was found to be significantly associated with knowledge score (p = 0.001). Conclusion This study demonstrates that physicians have poor knowledge and attitude levels regarding the usage of CBD in pediatric epilepsy. Therefore, more education is highly suggested before the introduction of this medication to Saudi patients.
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Affiliation(s)
- Renad M Alsolamy
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Talah Almaddah
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Ammar Aljabri
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Hadeel A Maaddawi
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | | | - Maha Gashlan
- Neurology, King Abdulaziz Medical City, Jeddah, SAU
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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] [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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Marchese M, Zhu C, Charbonneau LF, Peragine C, De Angelis C. Description and Disposition of Patients With Cancer Accessing a Novel, Pharmacist-Led Cannabis Consultation Service. JCO Oncol Pract 2022; 18:e1777-e1786. [PMID: 35609230 DOI: 10.1200/op.21.00748] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
PURPOSE The Cannabis Consultation Service (CCS) is an innovative pharmacist-led resource at the Sunnybrook Odette Cancer Centre. Its mandate is to provide education and guide patients through access and appropriate use of high-quality plant-derived cannabinoids (PDCs). Our objective was to describe the CCS, explain its processes, and characterize patient disposition with respect to use of PDCs. METHODS We retrospectively reviewed the charts of patients referred to the CCS from July 13, 2020, to March 05, 2021. We used descriptive statistics to report on the patient population and service metrics. RESULTS During the 34-week period, 96 patients accessed the CCS (median age, 61 years). The top reasons for CCS consultation were management of cancer pain, insomnia, and general interest. Medical cannabis was supported as an option in 44/96 patients. Reasons for not supporting PDC use included lack of indication, potential drug interaction/contraindication, or requiring treatment with first-line therapy. Of the 40 patients requiring a medical document, 22 initiated therapy. The most common product used was a 2:50 THC:CBD (Tetrahydrocannabinol:Cannabidiol) cannabis oil. At the date of last contact, few patients remained on therapy because of lack of benefit, patient choice, and/or hesitancy. CONCLUSION Despite patients with cancer having interest in seeking PDCs for symptom management, only a few initiated and continued therapy. Pharmacists have an opportunity to advise patients and the oncology team on the risks and benefits of PDCs. These results can be used to support the development of medical cannabis programs by oncology centers and focus future research priorities.
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Affiliation(s)
- Maria Marchese
- Department of Pharmacy, Sunnybrook Odette Cancer Centre, Toronto, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Catherine Zhu
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - L Flay Charbonneau
- Department of Pharmacy, Sunnybrook Odette Cancer Centre, Toronto, Canada
| | - Christine Peragine
- Department of Pharmacy, Sunnybrook Odette Cancer Centre, Toronto, Canada
| | - Carlo De Angelis
- Department of Pharmacy, Sunnybrook Odette Cancer Centre, Toronto, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.,Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
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15
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Nursing Students’ Knowledge, Skills, and Attitudes Regarding Medicinal Cannabis Care. JOURNAL OF NURSING REGULATION 2022. [DOI: 10.1016/s2155-8256(22)00082-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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16
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Vaillancourt R, Dhalla R, Merks P, Lougheed T, Goldfield G, Mansell H, Cameron J. Concerns, beliefs and attitudes of pharmacists and pharmacy students on cannabis use in Canada. Can Pharm J (Ott) 2022; 155:219-229. [PMID: 35813525 PMCID: PMC9266375 DOI: 10.1177/17151635221102143] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
BACKGROUND Since cannabis has been legalized in Canada for medical and recreational use, there has been an increased demand on pharmacists for cannabis counselling. The objective of this study was to determine the concerns, beliefs and attitudes of Canadian pharmacists and pharmacy students towards using cannabis. METHODS An online survey was synthesized under 3 broad themes: concerns, beliefs and attitudes about cannabis, consisting of 27 questions capturing demographics and Likert scale responding to survey questions. We examined whether there were differences in responses by geographic location (i.e., Ontario, Quebec, Canada), sex or practice setting (i.e., community, hospital). RESULTS Across Canada, there were 654 survey respondents, with 399 in Ontario and 95 in Quebec. Approximately 24% indicated they had used cannabis since legalization, 69% indicated they believed cannabis should be available for medical and recreational use and 34% indicated their perceptions towards cannabis had become more positive since legalization. Relative to Quebec or the rest of Canada, respondents from Ontario were significantly more likely to be comfortable providing counselling to and answering questions of patients on the safety and efficacy of medical cannabis use. Examining sex differences across Canada, male respondents were more comfortable than female counselling patients on the safety and efficacy of medical cannabis. CONCLUSION The current results reinforce the perceived need by pharmacists and pharmacy students for targeted education, and future research in cannabis education should consider potential gender differences in attitudes and beliefs surrounding cannabis therapy.
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Affiliation(s)
- Régis Vaillancourt
- Department of Pharmacy, Children’s Hospital of Eastern Ontario, Ottawa
- Department of Family Medicine, University of Ottawa Faculty of Medicine, Ottawa
| | | | - Piotr Merks
- Cardinal Stefan Wyszyński University, Faculty of Medicine, Warsaw and the Department of Pharmaceutical Technology, Faculty of Pharmacy, Collegium, Medicum, Bydgoszcz, Poland
| | - Taylor Lougheed
- Section of Emergency Medicine, Northern Ontario School of Medicine, Sudbury
| | - Gary Goldfield
- Healthy Active Living and Obesity (HALO) Research Group, Children’s Hospital of Eastern Ontario, Ottawa
| | - Holly Mansell
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan
| | - Jameason Cameron
- Department of Pharmacy, Children’s Hospital of Eastern Ontario, Ottawa
- Department of Family Medicine, University of Ottawa Faculty of Medicine, Ottawa
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Sokratous S, Kaikoush K, Mpouzika MD, Alexandrou G, Karanikola NM. Attitudes, beliefs and knowledge about medical cannabis among nurses and midwives in Cyprus: a cross-sectional descriptive correlational study. BMC Nurs 2022; 21:120. [PMID: 35585574 PMCID: PMC9118681 DOI: 10.1186/s12912-022-00887-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 04/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a lack of evidence on healthcare professionals' attitudes, knowledge, and beliefs about medical cannabis in Cyprus and across the world. Therefore, the present study aimed to explore the attitudes, beliefs, and knowledge about MC use among nurses and midwives in Cyprus. Special focus was given to differences across gender, age, religion, marital status, and years of work experience. METHODS A descriptive, cross-sectional correlational study with internal comparisons was conducted during the 26th Nurses and Midwives Congress in Cyprus. All active nurses and midwives (convenience sampling), from the private and national healthcare services (n = 526) were eligible to participate. To analyze the data, the Pearson Chi-square test for group differences was employed, and descriptive and inferential statistics were assessed. RESULTS The final sample population consisted of 232 nurses and midwives (response rate of 46.4%). In total, 67(28.9%) participants were male, and 165(71.1%) were female. Cypriot nurses and midwives reported lack of knowledge regarding the risks and benefits about MC use to patients. However, specific number of participants believed MC use was considered acceptable for the patients with persistent muscle spasms, insomnia/sleeping disorders, mental health conditions, and terminal illnesses. The vast majority of the participants believed that formal training on MC should be integrated into academic programs, and expressed the necessity of urgent training under the current curriculum, as well as, educational training programs about MC use should be integrated into the practice/clinical practice. Concerning the socio-demographic characteristics of the participants, gender had a statistically significant positive effect on participants' attitudes and beliefs about MC (p < 0.01, 26.8% vs. 13.4%). Male and unmarried participants reported higher frequency about cannabis use for recreational purposes, compared with female group (p < 0.01, 22.8%Vs 11.4%). Unmarried participants agreed that using cannabis might develop serious mental health risks compared with married participants group (p < 0.05, 77.9% vs. 66.8%). CONCLUSIONS The conclusions seem to be rather recommending in favor of MC use. Participants proposed enriching nursing curricula with theoretical and clinical/laboratory courses about MC during studies and clinical practice. Additional tailoring interventions should be established to decrease recreational cannabis use among Cypriot nurses and midwives.
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Affiliation(s)
- S Sokratous
- Assistant Professor, Department of Nursing, School of Health Sciences, Cyprus University of Technology, Vragadinou Street, Limassol, Cyprus.
| | - K Kaikoush
- PhD, Mental health Nurse, Cyprus Mental Health Services, Larnaca, Cyprus
| | - M D Mpouzika
- Assistant Professor, Critical Care Nursing, Advanced Emergency and Intensive Nursing Care, Department of Nursing, School of Health Sciences, Cyprus University of Technology, Vragadinou Street, Limassol, Cyprus
| | - G Alexandrou
- PhD(c), Mental health Nurse, Cyprus Mental Health Services, Nicosia, Cyprus
| | - N M Karanikola
- Associate Professor, Department of Nursing, School of Health Sciences, Faculty of Health Sciences, Mental Health Studies & Research Cyprus University of Technology Chair Cyprus University of Technology Vragadinou Street, Limassol, Cyprus
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Edelstein OE. Attitudes and beliefs of medicine and social work students about medical cannabis use for epilepsy. Epilepsy Behav 2022; 127:108522. [PMID: 34999501 DOI: 10.1016/j.yebeh.2021.108522] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 11/28/2021] [Accepted: 12/19/2021] [Indexed: 12/01/2022]
Abstract
The current study sought: (i) to explore whether health profession students possess formal medical cannabis (MC) education, feel prepared to answer questions about MC, and perceive it as an effective therapy for epilepsy; (ii) to assess students' attitudes and beliefs about MC use; and (iii) to explore the associations between students' background characteristics, MC-related attitudes and beliefs regarding its effectiveness for epilepsy. A sample of 310 students (141 from medicine and 169 from social work) voluntarily participated in the anonymous online survey. The vast majority (92.5%) indicated they had no formal education about MC, and only 11.2 % reported being prepared to answer clients' MC-related questions. Participants reported favorable beliefs about MC benefits, the need for training, and recreational marijuana use legalization. Less supportive attitudes were reported regarding MC risks. Prior cannabis use (e.g., self-use, friends, or family) and individuals from a secular background were associated with more positive beliefs about MC benefits and its legalization for recreational purposes. Prior recreational cannabis use [OR=1.541] and having friends who recreationally use the substance [OR=1.891] were associated with the belief that MC is an effective therapy for epilepsy. These findings indicate an urgent need for students' MC education to provide future physicians and social workers with MC-related capacities. Development of curricula and training programs in Israel are encouraged.
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Affiliation(s)
- Offer E Edelstein
- Ben-Gurion University of the Negev, The Spitzer Department of Social Work, Beer-Sheva 841050, Israel.
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19
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Miller OS, Elder EJ, Jones KJ, Gidal BE. Analysis of cannabidiol (CBD) and THC in nonprescription consumer products: Implications for patients and practitioners. Epilepsy Behav 2022; 127:108514. [PMID: 34998268 DOI: 10.1016/j.yebeh.2021.108514] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/15/2021] [Accepted: 12/15/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE Cannabidiol products remains largely unregulated in the US. Unlike the Rx formulation of CBD [EpidiolexR], little information is available regarding labeling accuracy (does the product contain what the label says it does), lot to lot variability, nor long-term product stability. Understanding these properties are fundamental if these products are to be used in patients with epilepsy, where product variability of traditional AEDs has been suspected to result in inadequate seizure control. Therefore, we analyzed commercial CBD products, including oils, aqueous products (i.e., beverages), and various Other products for cannabinoid content vs label claims and stability under United States Pharmacopeia (USP) standards. METHOD Samples were diluted and analyzed by HPLC for CBD, THC, and CBN concentrations in order to assess product label accuracy. Products with <90% of label claim CBD were denoted over-labeled, products with >110% of label claim CBD were denoted under-labeled, and products between 90% and 110% of label claim CBD were denoted appropriately labeled, per USP standards. RESULTS Among commercial CBD Oils (n = 11), mean CBD concentration vs label claim was 91.56% [95% CI, 66.02-117.10%], although 18.18% of oils (n = 2) made nonspecific label claims of "hemp extract" in lieu of CBD. Among all oils, 36.36% (n = 4) were appropriately labeled, another 36.4% (n = 4) of all oils were under-labeled, maximum 128.3% label claim, and finally, 9.09% (n = 1) of oils were over-labeled. The remaining 18.18% (n = 2) of oils lacked specific CBD label claims, minimum of 0.3 mg CBD per 1-ml "dose". THC was detected in 54.55% (n = 6) of oils with a maximum concentration of 0.2% w/v and a minimum concentration of 0.036% w/v. Cannabinol was detectable in only 9.1% (n = 1) of products at a concentration of 0.00465% w/v. Among aqueous products (n = 21) tested, only 66.67% (n = 14) gave specific CBD label claims, with mean CBD concentration vs label claim of 59.93% [95% CI, 38.24-81.63%]. Only 7.14% (n = 1) of aqueous products with a label claim were appropriately labeled, 14.29% (n = 2) were found to be under-labeled, and 78.57% (n = 11) over-labeled. THC was detected in 23.81% (n = 5) of aqueous products tested with a maximum THC concentration of 0.0005% w/v, and a minimum concentration of 0.0002% w/v. Cannabinol was detected in 9.52% (n = 2) of aqueous products, both at a concentration of 0.0015% w/v. "Other" products (n = 7) tested ranged from chocolate bars to transdermal patches. Some 42.86% (n = 3) gave specific CBD label claims, with mean CBD concentration vs label claim of 67.01% [95% CI, 0.87-133.14%]. Among these three "Other" products with specific label claims, 33% (n = 1) was appropriately labeled, and 66.67% (n = 2) were over-labeled, with CBD concentrations vs label claim ranging from a minimum of 39.30% to a maximum of 101.99%. The remaining 57.14% (n = 5) of "Other" products tested made nonspecific CBD label claims, denoting CBD content in terms of "full spectrum hemp extract" or "activated cannabinoids". One such product was labeled with a "40-50-mg CBD" range instead of a single, specific value. Tetrahydrocannabinol was detected in 71.43% (n = 5) of Other products tested with a maximum concentration of 0.0046% w/w, and a minimum concentration of 0.0008% w/w. Cannabinol was detected in 14.3% (n = 1) of Other products at a concentration of 0.0001% w/w. CONCLUSION We demonstrate that commercial CBD products, especially aqueous beverages, can show inconsistent labeling, vary largely from their label claims should they make them, and show lot-to-lot variability making dosing unpredictable.
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Affiliation(s)
- Owen S Miller
- University of Wisconsin, School of Pharmacy, 777 Highland Ave, Madison, WI 53705, United States.
| | - Edmund J Elder
- University of Wisconsin, School of Pharmacy, 777 Highland Ave, Madison, WI 53705, United States; University of Wisconsin - Zeeh Pharmaceutical Experiment Station, 777 Highland Ave, Madison, WI 53705-2222, United States.
| | - Karen J Jones
- University of Wisconsin - Zeeh Pharmaceutical Experiment Station, 777 Highland Ave, Madison, WI 53705-2222, United States.
| | - Barry E Gidal
- University of Wisconsin, School of Pharmacy, 777 Highland Ave, Madison, WI 53705, United States.
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OUP accepted manuscript. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2022; 30:204-214. [DOI: 10.1093/ijpp/riac005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/25/2022] [Indexed: 11/14/2022]
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MacCallum CA, Lo LA, Pistawka CA, Christiansen A, Boivin M, Snider-Adler M. A Clinical Framework for Assessing Cannabis-Related Impairment Risk. Front Psychiatry 2022; 13:883517. [PMID: 35832600 PMCID: PMC9272752 DOI: 10.3389/fpsyt.2022.883517] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/30/2022] [Indexed: 11/26/2022] Open
Abstract
Clinicians play an important role in promoting safe and responsible medical cannabis use. One essential component to safe use is considering a patient's risk of neurocognitive impairment. However, there remains a lack of practical guidance on how clinicians can evaluate this risk for medical cannabis patients. Here, a practical framework is presented for clinicians to assess and stratify cannabis-associated impairment risk. The proposed framework is intended to practically guide healthcare providers in gaining a more comprehensive review of a patient's impairment-related factors. This framework can be used to assess impairment risk for patients currently using or considering medical cannabis and is recommended for all patients who perform safety-sensitive duties. Healthcare providers (HCP) managing patient's medical cannabis or those conducting assessments to determine risk of impairment for safety-sensitive workplaces can utilize this framework to stratify patients' risk of impairment. Such assessments can inform patient-specific needs for support, education, and guidance, to ensure cannabis is used safely and responsibly.
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Affiliation(s)
- Caroline A MacCallum
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Lindsay A Lo
- Department of Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Carly A Pistawka
- Faculty of Science, University of British Columbia, Vancouver, BC, Canada
| | - April Christiansen
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | | | - Melissa Snider-Adler
- Department of Medicine, Faculty of Medicine, Queen's University School of Medicine, Kingston, ON, Canada
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Emmerling S, Martin B, Schmitz N. A survey of Wisconsin pharmacists about cannabinoid products: Are we ready to recommend? J Am Pharm Assoc (2003) 2021; 61:e71-e75. [PMID: 34456146 DOI: 10.1016/j.japh.2021.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/06/2021] [Accepted: 08/03/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND In today's culture, cannabis and its cannabinoids are used for both recreational and medicinal purposes. Patients are able to obtain medical and commercial cannabis products. Pharmacists should feel comfortable counseling their patients, given the increased interest, access, and use of these products. OBJECTIVES The objective of this survey was to assess the familiarity, attitudes, and knowledge of Wisconsin pharmacists regarding products containing cannabinoids. METHODS An anonymous, Web-based survey was administered to 511 Wisconsin pharmacists using the Pharmacy Practice Enhancement and Action Research Link. The survey was adapted from a nationally developed survey with established validity evidence. Survey items evaluated pharmacists' knowledge of the legality and the pharmacokinetic and pharmacodynamic properties of cannabis. The survey included knowledge (22 items), familiarity (14 items), and attitude (8 items) scales as well as pharmacist demographics and workplace type. Descriptive statistics, Fisher exact test, and Cronbach's alpha were calculated. RESULTS The survey had a response rate of 19.3%. Nearly 75% of respondents were unfamiliar with the testing practices and pesticide regulations on cannabis production. Pharmacists were also unfamiliar with doses related to commercially available cannabinoid products. A quarter reported that they counsel at least monthly on cannabinoid therapies, but results showed that the majority are uncomfortable with the pharmacology and pharmacotherapy of these compounds. Over two-thirds reported that they need further education on cannabinoids and ranked continuing pharmacy education credits and webinars as their preferred method of learning. Over two-thirds at least somewhat agreed that they would feel comfortable recommending a Food and Drug Administration (FDA)-approved treatment, but a similar proportion reported that they would not recommend non-FDA approved cannabinoid treatments. CONCLUSION Wisconsin pharmacists require more education to fill knowledge gaps regarding the therapeutic uses of cannabinoid products.
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Klein TA, Bindler R. Ask Your Provider About Cannabis: Increasing Nurse Practitioner Knowledge and Confidence. Cannabis Cannabinoid Res 2021; 7:700-705. [PMID: 34432530 PMCID: PMC9587772 DOI: 10.1089/can.2021.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction: Nurse practitioners (NPs) are authorizing providers for medical cannabis in many states, and may serve as a primary care clinician. We report findings from a nationally distributed 2-h continuing education (CE) module aimed to improve knowledge, confidence, and willingness to communicate with patients about cannabis. Methods: Data were electronically obtained from the CE platform pre- and post-test (n=289) and a follow-up survey sent within 3 months postcompletion (n=184, 63%). Pre- and post-testing assessed cannabis pharmacodynamics, law, evidence-based use, metabolism, pharmacokinetics, laboratory testing, adverse reactions, and drug–drug interactions. The subsequent survey asked about changes in practice behavior, including willingness and self-identified recommendations for use. Quantitative and qualitative descriptive analysis and repeated-measures analysis of variance were used to analyze CE impact. Results: Significant improvement in scores was noted from pretest to post-test for all content with a mean improvement of 39.3% (95% CI: 30.6–47.9%). The greatest increases were for metabolism, pharmacokinetics, and drug–drug interaction content. At follow-up, 52.2% reported that the CE changed their attitudes about cannabis and although 86% had rarely or never applied it yet in practice, 92% reported they were now likely to inquire about cannabis use in their patients and 84% were likely to counsel patients about it. Although self-identified recommendations overlapped by conditions, some were unique to CBD (complex regional pain syndrome, migraine, mood disorder, smoking cessation) and THC products (appetite, cachexia, depression, fibromyalgia, HIV, seizure disorder, stress, and weight loss). Pain was the most common condition for recommendation of both CBD and THC, followed by anxiety and arthritis. Conclusions: NPs gained key knowledge about cannabis, which may impact patient care and prescribing practices. The educational module resulted in more willingness to discuss and counsel patients about cannabis, even if practitioner attitudes did not change.
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Affiliation(s)
- Tracy A Klein
- College of Nursing, Washington State University Vancouver, Vancouver, Washington, USA
| | - Ross Bindler
- College of Nursing, Washington State University Spokane, Spokane, Washington, USA
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Jouanjus E, Sans-Pola C, Mainoli B, Javid FA, Ekheden I. Establishing and Evaluating a Study Questionnaire on Knowledge and Attitudes of Healthcare Professionals Towards Recreational and Medical Cannabis Across Europe. Clin Drug Investig 2021; 41:701-710. [PMID: 34232478 DOI: 10.1007/s40261-021-01058-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVE The present survey was a preliminary to a European research project on the attitude and knowledge of healthcare professionals towards the use of medical cannabis. The objective was to evaluate the readability, understandability, and relevance of a first version of the study questionnaire before preparing the finalized questionnaire, which will be subsequently proposed to European healthcare professionals on a large scale. METHODS A cross-sectional study was conducted between December 2019 and May 2020. We established an electronic evaluation questionnaire relating to the study questionnaire. This evaluation questionnaire was proposed to multidisciplinary experts from all over Europe. Feedback from the evaluation questionnaire was considered for improving and finalizing the study questionnaire. RESULTS 66 evaluation questionnaires were collected from nine European countries (Cyprus, France, Germany, Italy, Lithuania, Portugal, Spain, Sweden, United Kingdom), which corresponded to a participation rate of 41.5%. Most participants were women (65.2%, n = 43). The mean age was 39.5 years ± 11.6. Each participant could specify several occupations. There were 25 pharmacologists, 24 physicians, ten pharmacists, four university teachers, three epidemiologists or public health experts, one nurse, one biotechnologist, one microbiologist, and one police researcher. Overall, 84.8% of participants were interested in the topic of the survey on the knowledge and attitudes of healthcare professionals towards recreational and medical cannabis across Europe. Participants were satisfied with all but six of the proposed questions. In addition, two additional questions were subject for comments despite a high level of satisfaction. Consequently, the concerned questions (n = 8) were modified. CONCLUSION This evaluation survey was a necessary step to improve the quality of the future research project. The positive feedback encourages the authors to proceed with the project on a European scale, scheduled for 2021.
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Affiliation(s)
- Emilie Jouanjus
- Center for Epidemiology and Research in POPulation health (CERPOP), Team EQUITY, UMR Inserm-University of Toulouse, University of Toulouse III Paul Sabatier, Faculty of Medicine, 37 Allées Jules Guesde, 31000, Toulouse, France. .,Addictovigilance Center, Department of Medical Pharmacology, Toulouse University Hospital, Toulouse, France.
| | - Carla Sans-Pola
- Clinical Pharmacology service, Vall d'Hebron University Hospital, Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain.,Immunomediated diseases and Innovative Therapies research group, Institut de Recerca Vall d'Hebron, Barcelona, Spain
| | - Beatrice Mainoli
- Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Farideh A Javid
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Isabella Ekheden
- Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden
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Ng JY, Gilotra K, Usman S, Chang Y, Busse JW. Attitudes toward medical cannabis among family physicians practising in Ontario, Canada: a qualitative research study. CMAJ Open 2021; 9:E342-E348. [PMID: 33849983 PMCID: PMC8084545 DOI: 10.9778/cmajo.20200187] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Medical cannabis has been legally available in Canada since 2001, but its benefits and harms remain uncertain. We explored attitudes toward medical cannabis among family physicians practising in Ontario. METHODS Between January and October 2019, we conducted a qualitative study of Ontario family physicians using semistructured telephone interviews. We applied thematic analysis to interview transcripts and identified representative quotes. RESULTS Eleven physicians agreed to be interviewed, and 3 themes regarding medical cannabis emerged: reluctance to authorize use, concern over harms and lack of practical knowledge. Participants raised concerns about the limited evidence for, and their lack of education regarding, the therapeutic use of cannabis, particularly the harms associated with neurocognitive development, exacerbation of mental illness and drug interactions in older adults. Some participants thought medical cannabis was overly accessible and questioned their role following legalization of recreational cannabis. INTERPRETATION Despite the increasing availability of medical cannabis, family physicians expressed reluctance to authorize its use because of lack of knowledge and concerns regarding harms. Family physicians may benefit from guidance and education that address concerns they have surrounding medical cannabis.
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Affiliation(s)
- Jeremy Y Ng
- Departments of Health Research Methods, Evidence and Impact (Ng, Gilotra, Usman, Chang, Busse) and Anesthesia (Busse), Faculty of Health Sciences, McMaster University; The Chronic Pain Centre of Excellence for Canadian Veterans (Busse); The Michael G. DeGroote Centre for Medicinal Cannabis Research (Busse), McMaster University, Hamilton, Ont
| | - Kevin Gilotra
- Departments of Health Research Methods, Evidence and Impact (Ng, Gilotra, Usman, Chang, Busse) and Anesthesia (Busse), Faculty of Health Sciences, McMaster University; The Chronic Pain Centre of Excellence for Canadian Veterans (Busse); The Michael G. DeGroote Centre for Medicinal Cannabis Research (Busse), McMaster University, Hamilton, Ont
| | - Sana Usman
- Departments of Health Research Methods, Evidence and Impact (Ng, Gilotra, Usman, Chang, Busse) and Anesthesia (Busse), Faculty of Health Sciences, McMaster University; The Chronic Pain Centre of Excellence for Canadian Veterans (Busse); The Michael G. DeGroote Centre for Medicinal Cannabis Research (Busse), McMaster University, Hamilton, Ont
| | - Yaping Chang
- Departments of Health Research Methods, Evidence and Impact (Ng, Gilotra, Usman, Chang, Busse) and Anesthesia (Busse), Faculty of Health Sciences, McMaster University; The Chronic Pain Centre of Excellence for Canadian Veterans (Busse); The Michael G. DeGroote Centre for Medicinal Cannabis Research (Busse), McMaster University, Hamilton, Ont
| | - Jason W Busse
- Departments of Health Research Methods, Evidence and Impact (Ng, Gilotra, Usman, Chang, Busse) and Anesthesia (Busse), Faculty of Health Sciences, McMaster University; The Chronic Pain Centre of Excellence for Canadian Veterans (Busse); The Michael G. DeGroote Centre for Medicinal Cannabis Research (Busse), McMaster University, Hamilton, Ont.
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Isralowitz R, Reznik A, Zolotov Y, Grinstein-Cohen O, Wacht O, Pruginin I, Yehudai M, Edelstein O. Toward medical cannabis education in Israel. Complement Ther Med 2021; 58:102709. [PMID: 33716092 DOI: 10.1016/j.ctim.2021.102709] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 02/08/2021] [Accepted: 03/06/2021] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES To assess knowledge, attitudes and beliefs regarding medical cannabis among Israeli medical, nursing, social work and other health related students as well as to outline the formation of an instrument for standardized data collection on these topics. METHODS An invitation to participate with a link for the online survey was sent to all students pursuing a degree in medicine, nursing, social work, and other health disciplines in the Ben Gurion University of the Negev, Israel. The instrument included 32 items that measured knowledge, attitudes and beliefs regarding medical cannabis. In addition, demographic data were collected and participants were asked about the frequency of medical or recreational cannabis use. RESULTS Among the 763 participants, 596 were females (78 %), and the mean age was 25.8 years. While the reported personal use of medical cannabis was minimal (1.9 %), cannabis use for recreational purposes was relatively common (54.0 %). The vast majority believed that medical cannabis holds significant health benefits but expressed concerns regarding potential risks of cannabis use. Additionally, the vast majority of students felt unprepared to answer patients' questions about medical cannabis and expressed a desire to receive more training. Several significant differences between the different academic disciplines were observed. CONCLUSIONS In light of current regulatory and scientific developments, it is apparent that students of health professions will need a greater level of understanding of medical cannabis than previous generations of students. This study emphasizes the ample need for more knowledge and formal education to students of health and related professions.
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Affiliation(s)
- Richard Isralowitz
- Regional Alcohol and Drug Abuse Research (RADAR) Center, Ben Gurion University of the Negev, Beer Sheva, Israel.
| | - Alexander Reznik
- Regional Alcohol and Drug Abuse Research (RADAR) Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Yuval Zolotov
- Regional Alcohol and Drug Abuse Research (RADAR) Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Orli Grinstein-Cohen
- Department of Nursing, Toby Mower Curriculum for the Prevention and Treatment of Addiction, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Oren Wacht
- Department of Emergency Medical Services, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Itay Pruginin
- Regional Alcohol and Drug Abuse Research (RADAR) Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Mor Yehudai
- Regional Alcohol and Drug Abuse Research (RADAR) Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Offer Edelstein
- The Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Felnhofer A, Kothgassner OD, Stoll A, Klier C. Knowledge about and attitudes towards medical cannabis among Austrian university students. Complement Ther Med 2021; 58:102700. [PMID: 33677020 DOI: 10.1016/j.ctim.2021.102700] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 02/22/2021] [Accepted: 02/22/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The relevance of medical cannabis (MC) increases; and, educating those who are at the forefront of patient care is imperative. Yet, research on medical students' expertise and opinions is still scarce. OBJECTIVE This study set out to evaluate Austrian medical students' knowledge about and attitudes towards MC and compare them with other academic disciplines. Additionally, gender was controlled for. METHODS An online survey was conducted with N = 404 students enrolled in (1) medical studies, (2) studies with a medical background and (3) studies without a medical background. RESULTS In contrast to non-medical students, 64 % of medical students said they learnt about MC at the university. Although students were confident about their knowledge, they struggled to differentiate between CBD and THC. Chronic pain, oncological diseases and palliative care were the most frequently cited indications, psychiatric indications, however, were mentioned less often. Medical students were more reserved in their attitudes towards increasing medical usage and legalizing cannabis than the two other groups. Also, they were more skeptical about whether physicians should be allowed to prescribe MC and whether they should be obliged to offer it. Males showed more confidence regarding cannabis knowledge and were more favorable of legalizing and prescribing cannabis; females perceived cannabis as more physically addictive and as a gate-way drug. CONCLUSIONS Considering that beliefs and attitudes shape behavior, it is expected that future health care professionals will struggle with recommending cannabis for medical treatment. A coordinated approach for medical training is needed to ensure high standard medical care.
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Affiliation(s)
- Anna Felnhofer
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Pediatrics, CCP, Medical University of Vienna, Austria
| | - Oswald D Kothgassner
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Astrid Stoll
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Claudia Klier
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Pediatrics, CCP, Medical University of Vienna, Austria.
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Abstract
PURPOSE OF REVIEW To assess how the changing landscape of marijuana use affects the developing brain and mental health of college students. RECENT FINDINGS Legalization of cannabis may facilitate use in the college population, with 38% of college students, whose brains are still maturing, regularly using marijuana products. Earlier and increased use, higher potency, pre-existing issues, and genetic predispositions increase negative outcomes by precipitating or worsening mental illness and ultimately impacting academic success. In the USA, the sharpest increase in cannabis users following legalization has been in the college age population (18-25 years of age). This population is especially vulnerable to the negative impacts and risks associated with cannabis use, including risk for the onset of major psychiatric illness. College mental health practitioners should remain informed about health effects of cannabis use, assess patient use on a regular basis, provide education and be familiar with interventions to reduce harm.
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Affiliation(s)
- Ludmila De Faria
- Young Adult Clinic, University of Florida School of Medicine, Gainesville, FL, USA.
| | - Lillian Mezey
- Student Health, Counseling and Psychological Services, University of Virginia, Charlottesville, VA, USA
| | - Aaron Winkler
- College Mental Health Program, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Sokratous S, Mpouzika MDA, Kaikoushi K, Hatzimilidonis L, Koutroubas VS, Karanikola MNK. Medical cannabis attitudes, beliefs and knowledge among Greek-Cypriot University nursing students. Complement Ther Med 2021; 58:102707. [PMID: 33675934 DOI: 10.1016/j.ctim.2021.102707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/25/2021] [Accepted: 03/01/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES We aimed to explore the attitudes, beliefs and knowledge of nursing students about medical cannabis use in Cyprus. Special focus was given on gender differences and the year of studentship. DESIGN A descriptive, cross-sectional study with internal comparisons was performed on undergraduate nursing students in Cyprus. Pearson chi-square test for group differences was employed. A total of 252 questionnaires were anonymously and voluntarily completed. Descriptive and inferential statistics were assessed. RESULTS 21 % male and 79 % female were included in the sample (response rate 62.7 %). Third year student participants reported more frequent use of cannabis for all reasons - for themselves, friends and family (p < 0.05). Furthermore, they reported more positive statements on the effectiveness of medical cannabis in treating medical conditions (p < 0.05). Moreover, female students reported more frequently the necessity of incorporating medical cannabis training into academic curricula (p < 0.05). CONCLUSIONS Given the reported lack of knowledge, enrichment of nursing curricula with medical cannabis related courses and lectures, both theoretical and clinical/ laboratory, are proposed. The associations of attitudes with gender and years of studentship point to the need of taking these factors into consideration for relevant education and training.
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Affiliation(s)
- Sokratis Sokratous
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | | | - Katerina Kaikoushi
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
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Nichols MA, Arnett SJ, Fa B, Marchionda RA, Cutting MC, McDonald MR, Miller ML. National survey identifying community pharmacist preceptors' experience, knowledge, attitudes, and behaviors influencing intent to recommend cannabidiol products. J Am Pharm Assoc (2003) 2021; 61:S91-S104. [PMID: 33558186 DOI: 10.1016/j.japh.2021.01.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/18/2020] [Accepted: 01/09/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The primary study objective was to characterize community pharmacist preceptors' experience, clinical and legislative knowledge, attitudes, and behaviors regarding cannabidiol (CBD). The secondary study objective was to identify which of these factors influenced intent to recommend CBD products. METHODS A 36-item survey was used to collect respondent demographics, experience, knowledge, attitudes, and behaviors regarding CBD. Items assessing attitudes, behaviors, and intent were developed using the Theory of Planned Behavior (TPB). Community pharmacist preceptors for schools of pharmacy across the United States were eligible to complete an electronic survey open for 12 weeks from January to April 2020. Descriptive statistics were used to summarize respondent demographics, experience, knowledge, and TPB constructs. Ordinal logistic regression was used to evaluate which factors influenced intent. RESULTS The survey was disseminated to an estimated 2242 community pharmacist preceptors and received 295 responses (13.2% response rate). Of the 272 respondents who met eligibility criteria to progress through the survey, the survey was completed in its entirety by 236 respondents (86.8% completion rate). For experience items, most respondents (70.7%) reported receiving previous education on CBD. Almost half (48.4%) reported CBD sales in their pharmacies, whereas 89.1% reported answering clinical questions about CBD. For knowledge items, respondents performed poorly on CBD adverse effect and drug interaction items. Many respondents were not comfortable counseling on (49.0%) or recommending (56.1%) CBD products for patient use. Most (74.5%) believed more research was needed before they would feel comfortable recommending CBD products. Most (57.8%) reported not having reliable CBD resources available in their pharmacies. Subjective norms and previous CBD education or personal research were the only factors found to have direct influences on respondents' intent to recommend CBD products. CONCLUSION Opportunities exist to fill knowledge gaps, enhance confidence, and provide desired educational resources for community pharmacist preceptors on CBD products.
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Puteikis K, Mameniškienė R. Use of cannabis and its products among patients in a tertiary epilepsy center: A cross-sectional survey. Epilepsy Behav 2020; 111:107214. [PMID: 32580133 DOI: 10.1016/j.yebeh.2020.107214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/28/2020] [Accepted: 05/30/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study was to evaluate whether the topic of using cannabis as a treatment option for epilepsy is relevant among adult patients with the disorder and assess the possible determinant attitudes for having a history of cannabis consumption or being inclined to try it for medical purposes. MATERIAL AND METHODS Willing adult (≥18 years) patients with diagnosed epilepsy participated in a cross-sectional survey study at a tertiary epilepsy center. The questions were related to cannabis use and opinions towards the safety and efficacy profile of cannabis for treating epilepsy. RESULTS From 250 respondents, 41 (16.4%) reported prior use of cannabis or its preparations (15 [36.6%] for self-treatment). There were 81 (32.4%) participants further interested in cannabis use for treating epilepsy. In a binary regression model (Nagelkerke R2¯ = 0.331), the opinion that cannabis is safer because of its natural origin (β = 0.749, p = 0.027) and the premise of understanding its legal status (β = 0.418, p = 0.024) positively predicted which participants have reported cannabis use. These patients were also more likely to consult internet sources (p = 0.004) and agree that cannabis as an epilepsy treatment option is effective (U = 2231.5, p < 0.001), safe (U = 1822.0, p < 0.001) and has no side effects (U = 2470.5, p = 0.004). Patients who had not tried cannabis were more likely to envision the products as potentially addictive (p = 0.012) and presumably be deterred from using them due to beliefs in harmful effects (β = -0.632, p = 0.025). In general, nonusers were not inclined to try cannabis for treating epilepsy (Md = 2, range 1 to 7). However, those interested in the possibility of using cannabis to treat epilepsy would be more willing to try the respective preparations (p < 0.001). CONCLUSION Among adult patients with epilepsy, we report no particularly high rate of cannabis use or interest in applying cannabis for medical purposes. In order to clarify the scientific and legal status of the preparations, treating neurologists should consult prior users and patients interested in the possibility of trying cannabis as an epilepsy remedy.
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