Koslowsky Benjamin, Mazuz Betty, Ben-Ya'acov Ami, Neumark Aliza, Bar-Gil Shitrit Ariella, Goldin Eran
Dig Dis. 2021;39(5):502-507. doi: 10.1159/000514776. Epub 2021 Jan 27.
The use of medical cannabis (MC) for inflammatory bowel diseases (IBDs) is expanding. Current evidence does not support the efficacy of MC for reducing inflammation in IBD patients. Even so, many gastroenterologists encounter the issue of recommending use of MC to IBD patients.
A Web-based survey was completed by 84 (34%) gastroenterologists in Israel.
Out of 84 physicians whom completed the questionnaire, 59 (70%) were male, 34 (40%) were under age 50 years, 71 (85%) were adult gastroenterologists, and 53 (63%) work mainly in a hospital. Of them, 15, 41, and 44% of physicians think that MC is very effective, mildly effective, and not effective at all, respectively. Physicians will commonly, rarely, and never recommend MC in 31, 47, and 22%, respectively. Older physicians (above age 50 years) were significantly more likely to have a positive attitude towards MC in both questions. When presented with a clinical scenario of a patient in deep remission, requesting to increase the dose, 32% would increase, 49% would maintain, and only 18% would stop prescribing MC altogether; 48% of physicians did not know the recommended initial dose for MC. Only 2 (2.5%) physicians initiated the use of MC to all patients. Female gastroenterologists were significantly more likely to initiate MC, p = 0.048.
The use of MC for IBD patients is commonly encountered. Completely different attitudes regarding this treatment were seen. Age above 50 years and female physicians generally had a more positive attitude towards the use of MC. Guidelines and clear recommendations are needed.
医用大麻(MC)在炎症性肠病(IBD)中的应用正在扩大。目前的证据不支持MC对减轻IBD患者炎症的疗效。即便如此,许多胃肠病学家仍会遇到向IBD患者推荐使用MC的问题。
以色列84名(34%)胃肠病学家完成了一项基于网络的调查。
在完成问卷的84名医生中,59名(70%)为男性,34名(40%)年龄在50岁以下,71名(85%)为成人胃肠病学家,53名(63%)主要在医院工作。其中,分别有15%、41%和44%的医生认为MC非常有效、有一定效果和完全无效。医生通常、很少和从不推荐MC的比例分别为31%、47%和22%。在这两个问题上,年长的医生(50岁以上)对MC持积极态度的可能性显著更高。当面对一名病情深度缓解但要求增加剂量的患者的临床情景时,32%的医生会增加剂量,49%的医生会维持原剂量,只有18%的医生会完全停止开具MC;48%的医生不知道MC的推荐初始剂量。只有2名(2.5%)医生对所有患者都开始使用MC。女性胃肠病学家开始使用MC的可能性显著更高,p = 0.048。
IBD患者使用MC的情况很常见。对这种治疗存在截然不同的态度。50岁以上的医生和女性医生总体上对使用MC持更积极的态度。需要制定指南和明确的建议。