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老年人医用和非医用大麻使用的影响:系统评价方案。

Effects of medical and non-medical cannabis use in older adults: protocol for a scoping review.

机构信息

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

出版信息

BMJ Open. 2020 Feb 28;10(2):e034301. doi: 10.1136/bmjopen-2019-034301.

Abstract

INTRODUCTION

With its legalisation and regulation in Canada in 2018, the proportion of Canadians reporting cannabis use in 2019 increased substantially over the previous year, with half of new users being aged 45+ years. While use in older adults has been low historically, as those born in the 1950s and 1960s continue to age, this demographic will progressively have more liberal attitudes, prior cannabis exposure and higher use rates. However, older adults experience slower metabolism, increased likelihood of polypharmacy, cognitive decline and chronic physical/mental health problems. There is a need to enhance knowledge of the effects of cannabis use in older adults. The following question will be addressed using a scoping review approach: what evidence exists regarding beneficial and harmful effects of medical and non-medical cannabis use in adults >50 years of age? Given that beneficial and harmful effects of cannabis may be mediated by patient-level (eg, age, sex and race) and cannabis-related factors (eg, natural vs synthetic, consumption method), subgroup effects related to these and additional factors will be explored.

METHODS AND ANALYSIS

Methods for scoping reviews outlined by Arksey & O'Malley and the Joanna Briggs Institute will be used. A librarian designed a systematic search of the literature from database inception to June 2019. Using the OVID platform, Ovid MEDLINE will be searched, including Epub Ahead of Print and In-Process and Other Non-Indexed Citations, Embase Classic+Embase, and PsycINFO for reviews, randomised trials, non-randomised trials and observational studies of cannabis use. The Cochrane Library on Wiley will also be searched. Eligibility criteria will be older adult participants, currently using cannabis (medical or non-medical), with studies required to report a cannabis-related health outcome to be eligible. Two reviewers will screen citations and full texts, with support from artificial intelligence. Two reviewers will chart data. Tables/graphics will be used to map evidence and identify evidence gaps.

ETHICS AND DISSEMINATION

This research will enhance awareness of existing evidence addressing the health effects of medical and non-medical cannabis use in older adults. Findings will be disseminated through a peer-reviewed publication, conference presentations and a stakeholder meeting.

TRIAL REGISTRATION NUMBER

DOI 10.17605/OSF.IO/5JTAQ.

摘要

介绍

2018 年加拿大将大麻合法化和监管,2019 年报告使用大麻的加拿大人比例大幅高于前一年,其中一半新使用者年龄在 45 岁以上。尽管老年人的使用量历来较低,但随着 20 世纪 50 年代和 60 年代出生的人继续老龄化,这部分人口的态度将更加自由,之前接触过大麻的可能性更高,使用率也更高。然而,老年人的新陈代谢较慢,多药并用的可能性增加,认知能力下降,慢性身体/心理健康问题增加。需要加强对老年人使用大麻的影响的了解。本研究将采用范围综述方法解决以下问题:在 50 岁以上成年人中,医用和非医用大麻使用的有益和有害影响有哪些证据?鉴于大麻的有益和有害影响可能受到患者水平(如年龄、性别和种族)和大麻相关因素(如天然与合成、消费方式)的影响,将探讨与这些因素和其他因素相关的亚组效应。

方法和分析

将采用 Arksey 和 O'Malley 以及 Joanna Briggs 研究所概述的范围综述方法。一名图书管理员设计了一项系统的文献检索,从数据库成立到 2019 年 6 月。使用 OVID 平台,将在 Ovid MEDLINE 中搜索综述、随机试验、非随机试验和观察性研究的文献,包括 Epub Ahead of Print 和 In-Process 和其他非索引引文、Embase Classic+Embase 和 PsycINFO。威利的 Cochrane Library 也将被搜索。纳入标准为目前使用大麻(医用或非医用)的老年参与者,且研究需要报告与大麻相关的健康结果才能纳入。两名评审员将筛选引文和全文,人工智能将提供支持。两名评审员将图表数据。将使用表格/图形来绘制证据并确定证据差距。

伦理和传播

本研究将提高对现有证据的认识,这些证据涉及医用和非医用大麻对老年人健康的影响。研究结果将通过同行评议的出版物、会议演讲和利益相关者会议进行传播。

试验注册号

DOI 10.17605/OSF.IO/5JTAQ。

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