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医学大麻在肿瘤学中的给药途径、使用原因和批准适应症:范围综述。

Routes of administration, reasons for use, and approved indications of medical cannabis in oncology: a scoping review.

机构信息

Faculty of Nursing, University of Montreal, Montreal, QC, Canada.

Research Chair in Innovative Nursing Practices, Montreal, QC, Canada.

出版信息

BMC Cancer. 2022 Mar 24;22(1):319. doi: 10.1186/s12885-022-09378-7.

Abstract

INTRODUCTION

Some patients diagnosed with cancer use medical cannabis to self-manage undesirable symptoms, including nausea and pain. To improve patient safety and oncological care quality, the routes of administration for use of medical cannabis, patients' reasons, and prescribed indications must be better understood.

METHODS

Based on the Joanna Briggs Institute guidelines, a scoping review was conducted to map the current evidence regarding the use of medical cannabis in oncological settings based on the experiences of patients diagnosed with cancer and their healthcare providers. A search strategy was developed with a scientific librarian which included five databases (CINAHL, Web of Science, Medline, Embase, and PsycINFO) and two grey literature sources (Google Scholar and ProQuest). The inclusion criteria were: 1) population: adults aged 18 and over diagnosed with cancer; 2) phenomena of interest: reasons for cannabis use and/or the prescribed indications for medical cannabis; 3) context: oncological setting. French- or English-language primary empirical studies, knowledge syntheses, and grey literature published between 2000 and 2021 were included. Data were extracted by two independent reviewers and subjected to a thematic analysis. A narrative description approach was used to synthesize and present the findings.

RESULTS

We identified 5,283 publications, of which 163 met the eligibility criteria. Two main reasons for medical cannabis use emerged from the thematic analysis: limiting the impacts of cancer and its side effects; and staying connected to others. Our results also indicated that medical cannabis is mostly used for three approved indications: to manage refractory nausea and vomiting, to complement pain management, and to improve appetite and food intake. We highlighted 11 routes of administration for medical cannabis, with oils and oral solutions the most frequently reported.

CONCLUSION

Future studies should consider the multiple routes of administration for medical cannabis, such as inhalation and edibles. Our review highlights that learning opportunities would support the development of healthcare providers' knowledge and skills in assessing the needs and preferences of patients diagnosed with cancer who use medical cannabis.

摘要

简介

一些被诊断患有癌症的患者使用医用大麻来自我管理不良症状,包括恶心和疼痛。为了提高患者安全性和肿瘤学护理质量,必须更好地了解医用大麻的给药途径、患者的原因和规定的适应证。

方法

根据乔安娜·布里格斯研究所的指南,我们进行了一项范围综述,以根据患有癌症的患者及其医疗保健提供者的经验,绘制关于在肿瘤学环境中使用医用大麻的现有证据。与科学图书管理员一起制定了一项搜索策略,该策略包括五个数据库(CINAHL、Web of Science、Medline、Embase 和 PsycINFO)和两个灰色文献来源(Google Scholar 和 ProQuest)。纳入标准为:1)人群:18 岁及以上被诊断患有癌症的成年人;2)感兴趣的现象:使用大麻的原因和/或医用大麻的规定适应证;3)背景:肿瘤学环境。纳入 2000 年至 2021 年间发表的法语或英语的原始经验性研究、知识综合和灰色文献。由两名独立评审员提取数据,并进行主题分析。采用叙述性描述方法综合和呈现研究结果。

结果

我们确定了 5283 篇出版物,其中 163 篇符合入选标准。从主题分析中得出了使用医用大麻的两个主要原因:限制癌症及其副作用的影响;与他人保持联系。我们的研究结果还表明,医用大麻主要用于三种批准的适应证:管理难治性恶心和呕吐、补充疼痛管理以及改善食欲和食物摄入。我们强调了医用大麻的 11 种给药途径,其中油和口服溶液的报告最为常见。

结论

未来的研究应考虑医用大麻的多种给药途径,例如吸入和可食用形式。我们的综述强调,学习机会将支持发展医疗保健提供者评估使用医用大麻的癌症患者需求和偏好的知识和技能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d268/8953058/9356f2411fa6/12885_2022_9378_Fig1_HTML.jpg

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