Department of Ophthalmology, Medical Faculty Associates, The George Washington University School of Medicine and Health Sciences, Washington, DC.
Department of Psychology, The George Washington University, Washington, DC.
JAMA Ophthalmol. 2016 Mar;134(3):259-64. doi: 10.1001/jamaophthalmol.2015.5209.
Previous research has shown several limitations associated with the use of marijuana as a treatment for glaucoma. However, little is known regarding patients' perceptions toward using marijuana for glaucoma and their intentions to use this therapeutic alternative.
To identify factors among patients with glaucoma that could lead to intentions to use marijuana for treatment.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional survey study of 204 patients with glaucoma or suspected to have glaucoma was conducted at an academic-based glaucoma clinic in Washington, DC, between February 1 and July 31, 2013. Patients completed a self-administered survey assessing demographics, perceived severity of glaucoma, prior knowledge about marijuana use in glaucoma, past marijuana use, perceptions toward marijuana use (legality, systemic adverse effects, safety and effectiveness, and false beliefs), satisfaction with current glaucoma management, relevance of treatment costs, and intentions to use marijuana for glaucoma. Medical records were reviewed for disease severity. Data analysis was conducted from September 1, 2013, to September 30, 2015.
The main outcome was patients' intentions to use marijuana for glaucoma. Multiple linear regression analysis was conducted to identify factors associated with patients' intentions to use marijuana for glaucoma.
Of the 334 patients who were invited to participate in the study, 204 (61.1%) completed the survey. About half the participants were women (104 [51.0]%), and 82 (40.2%) were white. Regression analysis of 204 respondents indicated that perceptions of legality of marijuana use (β, 0.378; 95% CI, 0.205 to 0.444; P < .001), false beliefs regarding marijuana (β, 0.323; 95% CI, 0.236 to 0.504; P < .001), satisfaction with current glaucoma care (β, -0.222; 95% CI, -0.362 to -0.128; P < .001), and relevance of marijuana and glaucoma treatment costs (β, 0.127; 95% CI, 0.008 to 0.210; P = .04) were significantly associated with intentions to use marijuana for glaucoma treatment after controlling for demographic variables, disease severity, and previous marijuana use.
This study's findings suggest a need for more education on this topic for ophthalmologists to be able to protect patients with glaucoma against the increased acceptability among the public of using marijuana based on false perceptions of its therapeutic value in glaucoma therapy. Considering the strong influence of perceptions of the legality of marijuana use on intentions to use this substance as a treatment for glaucoma, patient education might be particularly relevant in states in which marijuana use for glaucoma is legal, as in the case of the current study's setting.
先前的研究表明,大麻作为治疗青光眼的方法存在一些局限性。然而,关于患者对使用大麻治疗青光眼的看法以及他们使用这种治疗替代方法的意愿,我们知之甚少。
确定青光眼患者中可能导致使用大麻治疗意图的因素。
设计、地点和参与者: 这是一项在华盛顿特区一家学术性青光眼诊所进行的横断面调查研究,于 2013 年 2 月 1 日至 7 月 31 日期间纳入了 204 名青光眼或疑似青光眼患者。患者完成了一份自我管理的调查,评估了人口统计学特征、青光眼严重程度、对大麻在青光眼治疗中应用的先前认知、过去的大麻使用情况、对大麻使用的看法(合法性、全身不良影响、安全性和有效性以及错误观念)、对当前青光眼管理的满意度、治疗费用的相关性以及使用大麻治疗青光眼的意愿。查阅了病历以评估疾病严重程度。数据分析于 2013 年 9 月 1 日至 2015 年 9 月 30 日进行。
主要结局是患者使用大麻治疗青光眼的意愿。进行了多元线性回归分析,以确定与患者使用大麻治疗青光眼的意愿相关的因素。
在邀请参加研究的 334 名患者中,有 204 名(61.1%)完成了调查。约一半的参与者为女性(104 [51.0]%),82 名(40.2%)为白人。对 204 名应答者的回归分析表明,大麻使用合法性的看法(β,0.378;95%置信区间,0.205 至 0.444;P <.001)、对大麻的错误观念(β,0.323;95%置信区间,0.236 至 0.504;P <.001)、对当前青光眼治疗的满意度(β,-0.222;95%置信区间,-0.362 至 -0.128;P <.001)以及大麻和青光眼治疗费用的相关性(β,0.127;95%置信区间,0.008 至 0.210;P =.04)与控制人口统计学变量、疾病严重程度和既往大麻使用后使用大麻治疗青光眼的意愿显著相关。
本研究结果表明,眼科医生需要对这一主题进行更多的教育,以便能够防止公众因对大麻治疗青光眼的治疗价值存在错误认识而增加对大麻的接受度,从而保护青光眼患者免受影响。考虑到大麻使用合法性的看法对使用这种物质作为青光眼治疗的意愿有很强的影响,在大麻使用合法的州,如本研究的情况,患者教育可能特别重要。