Department of Psychiatry and Psychology, Mayo Clinic Health System, Eau Claire, Wisconsin, USA.
Department of Famiily Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Cannabis Cannabinoid Res. 2024 Aug;9(4):1038-1047. doi: 10.1089/can.2023.0011. Epub 2023 May 23.
Dramatic shifts in marijuana laws, along with federal deregulation of hemp with the 2018 Farm Bill, have resulted in increased availability and use of cannabidiol (CBD) supplements throughout the United States (US). Given the rapid increase in CBD use in the U.S. general population, in this study, we aim to characterize primary care physician (PCP) attitudes and practice behaviors and to assess whether differences in provider attitudes and behaviors vary as a function of marijuana legalization (ML) status in the state of practice. Data are from an online provider survey on CBD supplement-related attitudes, beliefs, and behaviors administered to 508 PCPs as part of a larger mixed methods study. Participating PCPs were recruited from the Mayo Clinic Healthcare Network and provided medical care in primary care settings across four U.S. states (Minnesota, Wisconsin, Florida, and Arizona). The survey response rate was 45.4% (=236/508). According to providers, CBD was frequently brought up in PCP settings, typically by patients. PCPs were generally hesitant to screen for or discuss CBD with their patients and identified multiple barriers to open patient-provider dialogue about CBD. PCPs practicing in states that had passed ML were more receptive to patients using CBD supplements, whereas PCPs practicing in states that had not passed ML were more concerned about CBD-related side effects. Regardless of state ML status, most PCPs did not feel that they should be recommending CBD supplements to their patients. Most PCPs reported believing that CBD was unhelpful for most conditions for which it is marketed, with chronic non-cancer pain and anxiety/stress being exceptions. PCP respondents generally felt that they had insufficient knowledge/training around CBD. Results from this mixed methods study show that PCPs practicing in the U.S. rarely screen for or discuss CBD use with their patients and report several barriers to engage in proactive CBD-focused practice behaviors. Furthermore, survey results show that some PCP attitudes, practice behaviors, and barriers vary as a function of state ML status. These findings may guide medical education efforts and inform primary care practice modifications aimed at enhancing screening and monitoring of patient CBD use by PCPs.
随着大麻法律的急剧变化，以及联邦政府在 2018 年《农场法案》中对大麻的放松管制，大麻二酚 (CBD) 补充剂在美国各地的供应和使用有所增加。鉴于美国普通人群中 CBD 使用的快速增加，在这项研究中，我们旨在描述初级保健医生 (PCP) 的态度和实践行为，并评估提供者态度和行为的差异是否因实践所在州的大麻合法化 (ML) 状态而有所不同。 数据来自一项针对 CBD 补充剂相关态度、信念和行为的在线提供者调查，该调查针对 508 名 PCP 进行，作为一项更大的混合方法研究的一部分。参与的 PCP 是从梅奥诊所医疗保健网络招募的，他们在四个美国州（明尼苏达州、威斯康星州、佛罗里达州和亚利桑那州）的初级保健环境中提供医疗服务。 调查的回复率为 45.4%（=236/508）。根据提供者的说法，CBD 经常在 PCP 环境中被提及，通常是由患者提出的。PCP 通常不愿对患者进行 CBD 筛查或讨论，并且确定了开放患者与提供者关于 CBD 对话的多个障碍。在已通过 ML 的州执业的 PCP 对患者使用 CBD 补充剂更为接受，而在未通过 ML 的州执业的 PCP 对 CBD 相关副作用更为关注。无论州 ML 状态如何，大多数 PCP 都认为他们不应该向患者推荐 CBD 补充剂。大多数 PCP 报告称，他们认为 CBD 对其销售的大多数病症都没有帮助，慢性非癌性疼痛和焦虑/压力是例外。PCP 受访者普遍认为他们对 CBD 的了解/培训不足。 这项混合方法研究的结果表明，美国的 PCP 很少对患者进行 CBD 筛查或讨论，并且报告了一些障碍，以开展积极主动的 CBD 重点实践行为。此外，调查结果表明，一些 PCP 的态度、实践行为和障碍因州 ML 状态而异。这些发现可能为医学教育工作提供指导，并为旨在增强 PCP 对患者 CBD 使用的筛查和监测的初级保健实践修改提供信息。
