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关于大麻用于治疗目的的医患互动因提供者类型而异:一项试点研究。

Patient-provider interactions about cannabis for therapeutic purposes vary as a function of provider type: A pilot study.

作者信息

Achar Jivan, Budney Alan J, Struble Cara A

机构信息

Department of Economics, Dartmouth College, Hanover, New Hampshire, USA.

Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth College, Center for Technology and Behavioral Health, Lebanon, New Hampshire, USA.

出版信息

Am J Addict. 2025 May;34(3):277-288. doi: 10.1111/ajad.13656. Epub 2024 Oct 24.

Abstract

BACKGROUND AND OBJECTIVES

Limited evidence guides the efficacy and safety of cannabis for therapeutic purposes (CTP). Healthcare providers lack requisite knowledge to advise and support patients. This study aimed to describe and compare several aspects of initial CTP interactions across different provider types.

METHODS

Adult cannabis consumers (N = 507) from the United States completed an anonymous online survey about their initial CTP interaction with their healthcare provider. Providers were categorized into four groups (Mental Health [MH], Family Medicine [FM], Medical Clinics [MC], and Other Specialty [OS]). Analyses compared several aspects of the interaction (e.g., risk mitigation, recommendations, satisfaction/confidence) across groups.

RESULTS

Less than half of the sample reported discussion of cannabis risks (44.0%) or follow-ups at subsequent visits (46.7%). Recommendations (where to obtain, consumption method, dose, frequency, and authorization) were uncommon (9.7%-25.2%). While the MH group reported the highest rates of risk mitigation behaviors, regression models adjusted for sociodemographic and cannabis characteristics were largely nonsignificant. For recommendations, the MC group was more likely than the MH group to report receiving all recommendations (p < .05). Younger age and greater cannabis-related problems increased likelihood of risk mitigation and recommendations.

DISCUSSION AND CONCLUSIONS

CTP interactions focused on risk but generally lacked comprehensive recommendations that could potentially promote safe use. Data from provider perspectives could support the need for CTP guidelines and develop training for healthcare providers to promote safe CTP practices.

SCIENTIFIC SIGNIFICANCE

For the first time, this study explored several aspects of CTP interactions and compared experiences across a variety of providers.

摘要

背景与目的

关于大麻用于治疗目的(CTP)的疗效和安全性的证据有限。医疗保健提供者缺乏为患者提供建议和支持所需的知识。本研究旨在描述和比较不同类型提供者之间初始CTP互动的几个方面。

方法

来自美国的成年大麻消费者(N = 507)完成了一项关于他们与医疗保健提供者初始CTP互动的匿名在线调查。提供者被分为四组(心理健康[MH]、家庭医学[FM]、医疗诊所[MC]和其他专科[OS])。分析比较了各组之间互动的几个方面(如风险缓解、建议、满意度/信心)。

结果

不到一半的样本报告了对大麻风险的讨论(44.0%)或后续就诊时的随访(46.7%)。建议(获取地点、消费方法、剂量、频率和授权)并不常见(9.7%-25.2%)。虽然MH组报告的风险缓解行为发生率最高,但在对社会人口统计学和大麻特征进行调整的回归模型中,这些差异大多不显著。对于建议,MC组比MH组更有可能报告收到所有建议(p < 0.05)。年龄较小和与大麻相关的问题较多会增加风险缓解和建议的可能性。

讨论与结论

CTP互动侧重于风险,但通常缺乏可能促进安全使用的全面建议。来自提供者视角的数据可以支持制定CTP指南的必要性,并为医疗保健提供者开展培训以促进安全的CTP实践。

科学意义

本研究首次探讨了CTP互动的几个方面,并比较了不同提供者的经历。

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