Enablers, Barriers and Practical Applications of a Group-Based Pain Self-Management Program for Patients Receiving Medical Cannabis: A Qualitative Study of Patients and Clinicians.

BACKGROUND

Pain self-management (PSM) programs have demonstrated effectiveness as a pain management strategy, yet evidence remains scarce for patients with chronic pain treated with medical cannabis. We aimed to explore feasibility aspects and practical applications of developing and implementing a group-based PSM intervention in this context.

METHODS

Twenty-two semi-structured qualitative interviews were conducted with 10 chronic pain patients treated with cannabis and 12 clinicians from a range of expertise.

RESULTS

Overall, the interviewees believed that the proposed intervention is feasible; yet it is essential to consider the following aspects during program planning and implementation. Inductive thematic analysis of interview transcripts identified five major themes. The first is that the program enablers include the intrinsic benefits of therapeutic group dynamics, aligning expectations, and setting individual goals at program initiation. The second theme is the program barriers. These include expected challenges for participants due to behavioral and mental changes that necessitate high commitment, the challenge for the group leader in delivering an appropriate response to each participant's emotional narrative; and managing logistical issues. The third theme is the psychological experience of living with pain, with an emphasis on addressing patients' emotional perspectives within the program's framework, namely, their perceptions of pain, fear of pain, and the relations of such to past experiences. The fourth theme is the psychoeducation on pain and cannabis use, including the brain-pain connection and informed guidance regarding cannabis use. The fifth theme is the integration of guided movement and relaxation techniques in pain management, thus underscoring the importance of practice during the group sessions.

CONCLUSIONS

Our findings suggest key elements that may inform planning PSM-approach therapy groups, tailored to the particular needs of patients with chronic pain using medical cannabis.