From the Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA (KB); Department of Medical Oncology, Sidney Kimmel Cancer Center/Thomas Jefferson University, Philadelphia, PA (BW); College of Nursing, Thomas Jefferson University, Philadelphia, PA (JR); Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA (SP, ELK); Center for Social Medicine and Humanities, University of California, Los Angeles, CA (ELK).
J Am Board Fam Med. 2023 Aug 9;36(4):670-681. doi: 10.3122/jabfm.2022.220304R1.
Physicians' ability to guide their patients on the use of medical cannabis can vary widely and is often shaped by their training, experiences, and the regulations and policies of their state. The goal of this qualitative study is to understand how prepared physicians are to certify and advise their patients to use medical cannabis. A secondary goal is to explore how physicians integrate certification into their clinical practices, and what factors shape their decisions and behaviors around certification.
Using semi-structured interviews with 24 physicians authorized to certify patients to use medical cannabis in Pennsylvania, a state with a medical access only program, we explored how physicians are trained and set up their practices. Interviews were analyzed using a blend of directed and conventional, and summative content analysis.
Three main themes emerged from the data around training, system-level factors, and practice-level factors that shaped how physicians are trained and practice medical cannabis certification. Although participants were largely satisfied with their CME training, they noted areas for improvement and a need for more high-quality research. Participants also noted system-level factors that prohibited treating cannabis as a traditional medical therapy, including communication barriers between physicians and dispensaries and confusion about insurance coverage for certification exams.
Physicians require additional training to improve the operation of the medical cannabis program in Pennsylvania. Participants suggested that the program could be improved by reducing communication barriers between them, their patients, and the dispensaries around the product purchase, selection, use, and effectiveness of medical cannabis.
医生指导患者使用医用大麻的能力差异很大，通常受到其培训、经验以及所在州的法规和政策的影响。本定性研究的目的是了解医生在认证和为患者使用医用大麻提供建议方面的准备情况。次要目标是探讨医生如何将认证纳入其临床实践，以及哪些因素影响他们在认证方面的决策和行为。
我们对 24 名在宾夕法尼亚州获得认证患者使用医用大麻授权的医生进行了半结构化访谈，宾夕法尼亚州实行的是医疗准入仅方案。我们探讨了医生的培训和实践设置方式。使用定向和常规以及总结性内容分析对访谈进行了分析。
数据中出现了三个主要主题，涉及培训、系统层面因素和实践层面因素，这些因素影响了医生的培训和医用大麻认证实践。尽管参与者对他们的 CME 培训基本满意，但他们指出了需要改进的地方和更多高质量研究的需求。参与者还指出了一些系统层面的因素，这些因素阻碍了将大麻作为传统医疗疗法进行治疗，包括医生和药房之间的沟通障碍以及认证考试保险覆盖范围的混乱。
宾夕法尼亚州的医生需要额外的培训，以改善医用大麻计划的运作。参与者建议，可以通过减少他们、患者和围绕产品购买、选择、使用和医用大麻有效性的药房之间的沟通障碍来改进该计划。
