Bega Danny, Simuni Tanya, Okun Michael S, Chen Xinguang, Schmidt Peter
Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA.
Department of Neurology Center for Movement Disorders and Neurorestoration University of Florida Gainesville Florida USA.
Mov Disord Clin Pract. 2016 May 20;4(1):90-95. doi: 10.1002/mdc3.12359. eCollection 2017 Jan-Feb.
Legalization of the medical use of cannabis for Parkinson's disease (PD) has bypassed the traditional drug-approval process, leaving physicians with little evidence with which to guide patients.
The goal of this study was to gather data on the cannabis-related prescribing practices and views regarding potential risks and benefits of cannabis among experts caring for patients with PD.
An anonymous, 73-item online survey was conducted through an online service (SurveyMonkey) and included neurologists at all National Parkinson Foundation Centers of Excellence.
Fifty-six responders represented centers across 5 countries and 14 states. 23% reported some formal education on cannabis. Eighty percent of responders had patients with PD who used cannabis, and 95% were asked to prescribe it. Fifty-two percent took a neutral position on cannabis use with their patients, 9% discouraged use, and 39% encouraged it. Most believed that the literature supported use of cannabis for nausea (87%; n = 48), anxiety (60%; n = 33), and pain (86%; n = 47), but responses were divided with regard to motor symptoms. Most respondents expected that cannabis would worsen motivation (59%; n = 32), sleepiness (60%; n = 31), and hallucinations (69%; n = 37). In addition, most feared negative effects on short-term memory (75%; n = 42), long-term memory (55%; n = 31), executive functioning (79%; n = 44), and driving (96%; n = 54). Although many did not believe that cannabis should be recreational (50%; n = 28), most believed that it should be legalized for medicinal purposes (69.6%; n = 39).
This study provides data on the cannabis-related practices, beliefs, and attitudes of expert PD physicians. There is a lack of consensus that likely reflects a general knowledge gap and paucity of data to guide clinical practice.
大麻用于帕金森病（PD）的医疗用途合法化绕过了传统的药物审批程序，使得医生几乎没有证据来指导患者。
本研究的目的是收集有关照顾PD患者的专家中与大麻相关的处方实践以及对大麻潜在风险和益处的看法的数据。
通过在线服务（SurveyMonkey）进行了一项包含73个项目的匿名在线调查，调查对象包括所有国家帕金森基金会卓越中心的神经科医生。
56名受访者代表了来自5个国家和14个州的中心。23%的受访者报告接受过一些关于大麻的正规教育。80%的受访者有使用大麻的PD患者，95%的受访者被要求开具大麻处方。52%的受访者对与患者使用大麻持中立态度，9%的受访者不鼓励使用，39%的受访者鼓励使用。大多数人认为文献支持大麻用于治疗恶心（87%；n = 48）、焦虑（60%；n = 33）和疼痛（86%；n = 47），但对于运动症状的看法存在分歧。大多数受访者预计大麻会使动机（59%；n = 32）、嗜睡（60%；n = 31）和幻觉（69%；n = 37）恶化。此外，大多数人担心对短期记忆（75%；n = 42）、长期记忆（55%；n = 31）、执行功能（79%；n = 44）和驾驶（96%；n = 54）产生负面影响。尽管许多人认为大麻不应作为娱乐用途（50%；n = 28），但大多数人认为它应该用于医疗目的而合法化（69.6%；n = 39）。
本研究提供了关于PD专家医生与大麻相关的实践、信念和态度的数据。缺乏共识可能反映了普遍的知识差距以及指导临床实践的数据匮乏。
