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“一线希望”——澳大利亚和新西兰子宫内膜异位症患者对药用大麻的认知、障碍及驱动因素

"A glimmer of hope" - Perceptions, barriers, and drivers for medicinal cannabis use amongst Australian and New Zealand people with endometriosis.

作者信息

Sinclair Justin, Abbott Jason, Mikocka-Walus Antonina, Ng Cecilia H M, Sarris Jerome, Evans Subhadra, Armour Mike

机构信息

J Sinclair, Western Sydney University NICM Health Research Institute, Westmead, Australia.

J Abbott, University of New South Wales School of Women's and Children's Health, Randwick, Australia.

出版信息

Reprod Fertil. 2023 Oct 1;4(4). doi: 10.1530/RAF-23-0049.

Abstract

Previous quantitative research has shown that cannabis use, mostly illicit, is used for symptom management amongst those with endometriosis living in Australia or New Zealand, but the drivers and barriers for use of legal, medicinal cannabis in this population are currently unclear. This study sought to investigate, via online focus-groups, the perceptions, barriers, drivers, and experiences associated with cannabis use, whether legal or illicit, amongst 37 Australians and New Zealanders, aged 18-55, with a medical diagnosis of endometriosis. Previous cannabis usage was not required to participate. Discussion topics included strategies employed to manage symptoms, exploration of current medications, previous use of cannabis for pain management, and interest in using medicinal cannabis as a management strategy. Participants with moderate to severe symptoms of medically diagnosed endometriosis reported inadequacies with their current medical and self-management strategies and were inclined to try medicinal cannabis, both as part of their medical management and as part of a clinical trial. Barriers to medicinal cannabis adoption identified in this cohort included high costs of legal cannabis products, lack of clarity and fairness in current roadside drug testing laws and workplace drug testing policies, concern over the impact of stigma affecting familial, social and workplace life domains, and subsequent judgement and the lack of education/engagement from their medical providers regarding cannabis use. Given the interest in medicinal cannabis and the reported lack of effective symptom management, clinical trials are urgently required to determine the potential role that medicinal cannabis may play in reducing the symptoms of endometriosis.

摘要

以往的定量研究表明,在澳大利亚或新西兰患有子宫内膜异位症的人群中,大麻使用(大多为非法使用)被用于症状管理,但目前尚不清楚该人群使用合法医用大麻的驱动因素和障碍。本研究旨在通过在线焦点小组,调查37名年龄在18至55岁之间、被医学诊断为子宫内膜异位症的澳大利亚人和新西兰人使用大麻(无论合法或非法)的认知、障碍、驱动因素和经历。参与研究无需有大麻使用史。讨论话题包括用于管理症状的策略、对当前药物的探索、以往使用大麻进行疼痛管理的情况,以及对使用医用大麻作为管理策略的兴趣。患有医学诊断的子宫内膜异位症且症状为中度至重度的参与者报告称,他们当前的医疗和自我管理策略存在不足,并倾向于尝试医用大麻,将其作为医疗管理的一部分以及临床试验的一部分。该队列中确定的医用大麻采用障碍包括合法大麻产品成本高昂、当前路边药物检测法律和工作场所药物检测政策缺乏清晰度和公平性、担心污名化对家庭、社会和工作生活领域的影响以及随之而来的评判,以及医疗服务提供者对大麻使用缺乏教育/参与。鉴于对医用大麻的兴趣以及报告中缺乏有效的症状管理,迫切需要进行临床试验,以确定医用大麻在减轻子宫内膜异位症症状方面可能发挥的潜在作用。

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本文引用的文献

1
ESHRE guideline: endometriosis.ESHRE 指南:子宫内膜异位症。
Hum Reprod Open. 2022 Feb 26;2022(2):hoac009. doi: 10.1093/hropen/hoac009. eCollection 2022.

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