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治疗还是不治疗?波兰医生对大麻素临床方面的看法——一项在线调查。

To Treat or Not to Treat? Polish Physicians' Opinions about the Clinical Aspects of Cannabinoids-An Online Survey.

作者信息

Hordowicz Martyna Joanna, Jarosz Jerzy, Klimkiewicz Anna, Czaplińska Małgorzata, Leonhard Agnieszka, Wysocka Maria

机构信息

Hospice of St. Christopher in Warsaw, 02-781 Warsaw, Poland.

Polish Society of Medical Cannabis and Cannabinoids, 02-781 Warsaw, Poland.

出版信息

J Clin Med. 2022 Jan 1;11(1):236. doi: 10.3390/jcm11010236.

Abstract

INTRODUCTION

Medical cannabis' importance in Poland increased dramatically following its legalization as the 12th country in Europe in 2017. However, no studies have been published to give insight into Polish physicians' opinions about medical cannabis.

OBJECTIVES

To investigate physician's opinions about cannabinoids' utility in clinical practice, concerns regarding their safety profile, and their clinical experience with cannabinoids.

METHODS

The survey using a self-developed tool was conducted online; participants were physicians with or without specialist training. Participation was voluntary. Physicians were recruited through personal networks, palliative care courses, and Medical Chambers.

RESULTS

From June to October 2020, we recruited 173 physicians from 15/16 voivodeships. The largest age group (43.9%; = 76) was 30-39 year-olds. A similar proportion declared they never used cannabis and did not receive any training regarding cannabinoids (60% for both). Only 15 (8%) ever prescribed medical cannabis, although about 50% declared knowing suitable patients for such therapy, and 53.8% had at least one patient proactively asking for such treatment in the last 6 mo. The most common indication chosen was pain: chronic cancer-related ( = 128), chronic non-cancer ( = 77), and neuropathic ( = 60). Other commonly chosen conditions were alleviation of cancer treatment side-effects ( = 56) and cachexia ( = 57). The overall safety profile of THC was assessed as similar to most commonly used medications, including opioids; NSAIDs and benzodiazepines were, however, perceived as safer.

CONCLUSIONS

Polish physicians favored the legalization of medical cannabis. However, it is of concern that a limited number have any experience with prescribing cannabis. The creation of clear guidelines to advise physicians in their routine practice and education about pain management and the risks related to the consumption of recreational cannabis for medical conditions are needed.

摘要

引言

2017年,波兰成为欧洲第12个将医用大麻合法化的国家,此后其在波兰的重要性急剧增加。然而,尚未发表任何研究来深入了解波兰医生对医用大麻的看法。

目的

调查医生对大麻素在临床实践中的效用、对其安全性的担忧以及他们使用大麻素的临床经验。

方法

使用自行开发的工具进行在线调查;参与者为有或没有专科培训的医生。参与是自愿的。通过个人网络、姑息治疗课程和医学协会招募医生。

结果

2020年6月至10月,我们从15/16个省招募了173名医生。最大的年龄组(43.9%;n = 76)是30 - 39岁的人。相似比例的人宣称他们从未使用过大麻且未接受过任何关于大麻素的培训(两者均为60%)。只有15人(8%)曾开过医用大麻处方,尽管约50%的人宣称知道适合此类治疗的患者,并且53.8%的人在过去6个月中至少有一名患者主动要求进行此类治疗。最常选择的适应证是疼痛:慢性癌症相关(n = 128)、慢性非癌症(n = 77)和神经性(n = 60)。其他常选择的病症是缓解癌症治疗副作用(n = 56)和恶病质(n = 57)。四氢大麻酚的总体安全性被评估为与包括阿片类药物在内的最常用药物相似;然而,非甾体抗炎药和苯二氮䓬类药物被认为更安全。

结论

波兰医生赞成医用大麻合法化。然而,令人担忧的是,只有少数人有开具大麻处方的经验。需要制定明确的指南,以指导医生在日常实践中进行疼痛管理,并就医疗状况下使用娱乐性大麻的风险开展教育。

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