JSS Medical Research, St-Laurent, QC, Canada.
Southlake Regional Health Centre, Newmarket, ON, Canada.
Clin Exp Rheumatol. 2023 Jan;41(1):118-125. doi: 10.55563/clinexprheumatol/b85xu5. Epub 2022 May 23.
Medical cannabis is often used to alleviate common symptoms in patients with chronic conditions. With cannabis legalisation in Canada and easier access, it is important that rheumatologists understand its potential impact on their practice. Among patients attending rheumatology clinics in Ontario we assessed: the prevalence of medical cannabis use; symptoms treated; rheumatologists' perceptions.
Eight rheumatology clinics recruited consecutive adult patients in a 3-part medical cannabis survey: the first completed by rheumatologists; the second by all patients; the third by medical cannabis users. Student's t-test and Chi-square test were used to compare medical cannabis users to never users.
799 patients participated, 163 (20.4%) currently using medical cannabis or within <2 years and 636 never users; most had rheumatoid arthritis (37.8%) or osteoarthritis (34.0%). Compared to never users, current/past-users were younger; more likely to be taking opioids/anti-depressants, have psychiatric/gastrointestinal disorders, and have used recreational cannabis (p<0.05); had higher physician (2.9 vs. 2.1) and patient (6.0 vs. 4.2) global scores, and pain (6.2 vs. 4.7) (p<0.0001). Pain (95.5%), sleeping (82.3%) and anxiety (58.9%) were the most commonly treated symptoms; 78.2% of current/past-users reported medical cannabis was at least somewhat effective. Most rheumatologists reported being uncomfortable to authorise medical cannabis, primarily due to lack of evidence, knowledge, and product standardisation.
Medical cannabis use among rheumatology patients in Ontario was two-fold higher than that reported for the general population of similar age. Use was associated with more severe disease, pain, and prior recreational use. Reported lack of research, knowledge, and product standardisation were barriers for rheumatologist use authorisation.
医用大麻常用于缓解慢性疾病患者的常见症状。随着加拿大医用大麻合法化以及获取途径更加便捷，了解其对风湿科医生实践的潜在影响变得尤为重要。我们评估了安大略省风湿科诊所就诊患者中：医用大麻使用的流行率、治疗的症状、风湿科医生的看法。
8 家风湿科诊所招募了 3 部分医用大麻调查的连续成年患者：第一部分由风湿科医生完成；第二部分由所有患者完成；第三部分由医用大麻使用者完成。使用学生 t 检验和卡方检验比较医用大麻使用者和从不使用者。
799 名患者参与，163 名（20.4%）当前或<2 年内使用医用大麻，636 名从不使用者；大多数患者患有类风湿关节炎（37.8%）或骨关节炎（34.0%）。与从不使用者相比，当前/过去使用者年龄较小；更有可能使用阿片类药物/抗抑郁药、患有精神疾病/胃肠道疾病，并且使用过娱乐性大麻（p<0.05）；医生（2.9 分比 2.1 分）和患者（6.0 分比 4.2 分）整体评分和疼痛（6.2 分比 4.7 分）更高（p<0.0001）。疼痛（95.5%）、睡眠（82.3%）和焦虑（58.9%）是最常治疗的症状；78.2%的当前/过去使用者报告医用大麻至少有些效果。大多数风湿科医生报告称批准医用大麻感到不适，主要是由于缺乏证据、知识和产品标准化。
安大略省风湿科患者中医用大麻的使用率是相似年龄普通人群报告的两倍。使用与更严重的疾病、疼痛和先前的娱乐性使用有关。报告的缺乏研究、知识和产品标准化是风湿科医生批准使用的障碍。
