Yusupov Eleanor, Lopez Stephanie, Pino Maria A
Department of Clinical Specialties, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY, USA.
Medical Library, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY, USA.
Med Cannabis Cannabinoids. 2025 May 14;8(1):58-64. doi: 10.1159/000546264. eCollection 2025 Jan-Dec.
As legalization of medical cannabis (MC) in the USA expands, there remains uncertainty in clinical guidance. Healthcare professionals remain unprepared to communicate to patients the therapeutic outcomes and possible adverse effects of MC utilization. There is limited training provided at all levels of medical education, even for professionals with many years of clinical practice. Additionally, there is minimal scientific research, which delays the development of evidence-based guidelines.
This review followed established methodological approaches for scoping reviews according to PRISMA-ScR guidelines. Studies were included if they addressed the attitudes and beliefs of medical practitioners in the USA and were published after the year 2000.
There were forty-one studies from January 2013 to February 2025 included in the format of both electronic surveys and qualitative interviews. Participants included US physicians, other healthcare professionals, and medical trainees, representing multiple clinical specialties. Physicians reported lack of confidence in counseling patients or managing their use of MC. Oncologists, emergency medicine physicians, pain management specialists, and primary care physicians perceived that MC is beneficial for managing chronic pain, nausea, loss of appetite, depression, and other symptoms. Obstetric providers had unfavorable perceptions about perinatal use of MC. Physicians practicing in states where the drug has been legalized and those with greater years of practice were more comfortable recommending MC and counseling patients.
US physicians and medical trainees perceived significant knowledge barriers to recommending MC and counseling patients on its therapeutic use. Implementing clear clinical practice guidelines, further education on these drugs in clinical curriculums, and enhancing continuing education offerings would improve prescriber confidence. Increased research could also assist medical professionals in appropriate clinical decision making.
随着美国医用大麻合法化范围的扩大,临床指导仍存在不确定性。医疗保健专业人员仍未做好准备,无法向患者传达使用医用大麻的治疗效果和可能的不良反应。各级医学教育提供的培训有限,即使是对于有多年临床实践经验的专业人员也是如此。此外,科学研究极少,这延缓了循证指南的制定。
本综述遵循PRISMA-ScR指南中既定的范围综述方法。如果研究涉及美国执业医师的态度和信念且于2000年后发表,则纳入研究。
2013年1月至2025年2月期间共有41项研究,采用电子调查和定性访谈的形式。参与者包括美国医生、其他医疗保健专业人员和医学实习生,代表多个临床专业。医生报告称,在为患者提供咨询或管理其医用大麻使用方面缺乏信心。肿瘤学家、急诊医学医生、疼痛管理专家和初级保健医生认为,医用大麻有助于管理慢性疼痛、恶心、食欲不振、抑郁和其他症状。产科医疗服务提供者对围产期使用医用大麻持负面看法。在该药物已合法化的州执业的医生以及执业年限较长的医生在推荐医用大麻和为患者提供咨询方面更为自在。
美国医生和医学实习生认为,在推荐医用大麻并就其治疗用途为患者提供咨询方面存在重大知识障碍。实施明确的临床实践指南、在临床课程中对这些药物进行进一步教育以及增加继续教育课程将提高开处方者的信心。更多的研究也有助于医疗专业人员做出适当的临床决策。