Syed Shariful A, Singh Jatinder, Elkholy Hussien, Palavra Irena Rojnic, Tomicevic Marko, Eric Anamarija Petek, da Costa Mariana Pinto, Guloksuz Sinan, Radhakrishnan Rajiv
Department of Psychiatry, Yale School of Medicine, CT, USA.
Department of Psychiatry, Penn State Milton S. Hershey Medical Center, PA, USA.
medRxiv. 2023 Jul 27:2023.07.26.23293157. doi: 10.1101/2023.07.26.23293157.
The trends of recreational use of cannabis and use of cannabis for medical indications (i.e. "medical cannabis") have grown in recent years. Despite that, there is still limited scientific evidence to guide clinical decision-making and the strength of evidence for the medical use of cannabis is currently considered to be low. In contrast, there's growing evidence for negative health outcomes related to use of cannabis. In this rapidly shifting landscape, the role of physician's attitudes regarding the therapeutic value of cannabis has become essential. This study aimed to characterize knowledge/experience, attitudes, and potential predictors of clinical practice regarding medical cannabis.
We conducted a cross-sectional survey of physicians from 17 countries between 2016-2018. The survey comprised of 28 questions designed to explore physician knowledge, attitude, and practices regarding the use of medical cannabis. Descriptive statistics were used to examine willingness to recommend medical cannabis for medical and psychiatric indications, followed by regression analysis to identify predictors of physician willingness to recommend medical cannabis.
A total of 323 physicians responded to the survey. Mean age was 35.4± 9.5 years, with 10.04 ±8.6 years of clinical experience. 53 percent of physicians were women. Clinical experience with medical cannabis was overall limited (51.4% noted never having recommended medical cannabis; 33% noted inadequate knowledge regarding medical cannabis). Overall willingness to recommend medical cannabis was highest for chemotherapy-induced nausea, refractory chronic neuropathic pain, and spasticity in amyotropic lateral sclerosis (ALS).
This international study examining knowledge, attitudes and practices related to medical cannabis among physicians revealed that there are significant gaps in domain-specific knowledge related to medical cannabis. There is wide variability in willingness to recommend medical cannabis that is not consistent with the current strength of evidence. This study thus highlights the need for greater education related to domain-specific knowledge about medical cannabis.
近年来，大麻的娱乐性使用及用于医疗目的（即“医用大麻”）的趋势有所增长。尽管如此，仍缺乏足够的科学证据来指导临床决策，目前大麻医用证据的强度被认为较低。相比之下，与大麻使用相关的负面健康结果的证据却在不断增加。在这一快速变化的形势下，医生对大麻治疗价值的态度变得至关重要。本研究旨在描述医生关于医用大麻的知识/经验、态度以及临床实践的潜在预测因素。
我们在2016年至2018年间对来自17个国家的医生进行了一项横断面调查。该调查包含28个问题，旨在探究医生关于医用大麻使用的知识、态度和实践。使用描述性统计来检验推荐医用大麻用于医疗和精神科适应症的意愿，随后进行回归分析以确定医生推荐医用大麻意愿的预测因素。
共有323名医生回复了调查。平均年龄为35.4±9.5岁，临床经验为10.04±8.6年。53%的医生为女性。医生对医用大麻的临床经验总体有限（51.4%表示从未推荐过医用大麻；33%表示对医用大麻的知识不足）。推荐医用大麻的总体意愿在化疗引起的恶心、难治性慢性神经性疼痛以及肌萎缩侧索硬化症（ALS）的痉挛方面最高。
这项针对医生关于医用大麻的知识、态度和实践的国际研究表明，在与医用大麻相关的特定领域知识方面存在重大差距。推荐医用大麻的意愿差异很大，与当前的证据强度不一致。因此，本研究强调了加强关于医用大麻特定领域知识教育的必要性。
