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Indications and administration practices amongst medical cannabis healthcare providers: a cross-sectional survey.
BMC Family Practice ( IF 2.9 ) Pub Date : 2019-12-14 , DOI: 10.1186/s12875-019-1059-8
Jamie Corroon 1, 2 , Michelle Sexton 3, 4 , Ryan Bradley 2, 4, 5
Affiliation  

BACKGROUND The medical use of cannabis has been legislatively restricted for decades in the US and abroad. In recent years, changing local and national policies have given rise to a community of healthcare providers who may be recommending the medical use of cannabis without the benefit of formal clinical practice guidelines or sufficient training and education. In addition, a citizen science movement has emerged whereby unlicensed and untrained individuals are acting as healthcare provider proxies, offering cannabis-specific clinical care to "patients". This study sought to characterize the clinical practice characteristics of these provider groups. METHODS An anonymous, online survey was designed to describe levels of cannabis-specific education, practice characteristics, indications for medical use, dose, administration forms and adverse effects related to cannabis use. The questionnaire was disseminated via professional medical cannabis associations and by word-of-mouth. It was accessed between June 31-December 31, 2018. A self-selecting sample of respondents (n = 171) completed the survey. RESULTS Formal education or training in the medical use of cannabis was significantly more common among licensed respondents than unlicensed respondents (95.5% vs 76.9% respectively, OR, 6.3, 95% CI, 1.2-32.3, p = 0.03). The vast majority (n = 74, 83.15%) of licensed respondents reported having recommended cannabis as an adjunct to an existing prescription drug. Almost two-thirds (n = 64, 71.9%) reported having recommended it as a substitute. When delta-9-tetrahydrocannabinol (THC) is the principal therapeutic constituent of interest, vaporization is the most common method of administration recommended (n = 94 responses, 71.4% of respondents). In contrast, when cannabidiol (CBD) is the principal therapeutic constituent of interest, oral administration (sublingual or oromucosal absorption) is the most common method (n = 70 responses, 71.4% of respondents). CONCLUSIONS Individuals who recommend the medical use of cannabis appear to be self-generating a community standard of practice in the absence of formal clinical guidelines on dosing, interactions and other characteristics. Reducing barriers to clinical research on cannabis products is needed, not only to better understand their risks and benefits, but also to augment the evidence-base for informing clinical practice.

中文翻译:

医用大麻医疗保健提供者之间的适应症和管理实践:横断面调查。

背景技术大麻在医学上的使用在美国和国外已有数十年的立法限制。近年来,不断变化的地方和国家政策引起了医疗保健提供者群体的兴起,他们可能会建议在不使用正式临床实践准则或没有足够培训和教育的情况下,对大麻进行医学使用。此外,还出现了一项公民科学运动,据此,未经许可和未经培训的个人充当医疗保健提供者的代理,为“患者”提供大麻特有的临床护理。这项研究试图表征这些提供者群体的临床实践特征。方法一项匿名的在线调查旨在描述大麻的特殊教育水平,实践特点,医疗用途,剂量,给药形式以及与使用大麻有关的不利影响。通过专业的医疗大麻协会和口碑传播了调查表。在2018年6月31日至12月31日之间访问了该调查表。一个自我选择的受访者样本(n = 171)完成了调查。结果在有执照的受访者中,进行大麻医学使用的正规教育或培训明显比无执照的受访者更为普遍(分别为95.5%和76.9%,或为6.3、95%CI,1.2-32.3,p = 0.03)。绝大多数(n = 74,83.15%)的持牌受访者表示推荐使用大麻作为现有处方药的辅助剂。近三分之二(n = 64,71.9%)表示已推荐使用它作为替代品。当delta-9-tetrahydrocannabinol(THC)是主要的治疗成分时,汽化是推荐的最常见的给药方法(n = 94,占应答者的71.4%)。相比之下,当大麻二酚(CBD)是主要的治疗成分时,口服给药(舌下或口腔粘膜吸收)是最常见的方法(n = 70响应,占受访者的71.4%)。结论在没有关于剂量,相互作用和其他特征的正式临床指南的情况下,建议医学上使用大麻的人似乎是在自我形成社区实践标准。需要减少对大麻产品进行临床研究的障碍,这不仅是为了更好地了解其风险和益处,而且还需要扩大为临床实践提供依据的证据基础。当大麻二酚(CBD)是主要的治疗成分时,口服给药(舌下或口腔粘膜吸收)是最常见的方法(n = 70,占71.4%)。结论在没有关于剂量,相互作用和其他特征的正式临床指南的情况下,建议医学上使用大麻的人似乎是在自我形成社区实践标准。需要减少对大麻产品进行临床研究的障碍,这不仅是为了更好地了解其风险和益处,而且还需要扩大为临床实践提供依据的证据基础。当大麻二酚(CBD)是主要的治疗成分时,口服给药(舌下或口腔粘膜吸收)是最常见的方法(n = 70,占71.4%)。结论在没有关于剂量,相互作用和其他特征的正式临床指南的情况下,建议医学上使用大麻的人似乎是在自我形成社区实践标准。需要减少对大麻产品进行临床研究的障碍,这不仅是为了更好地了解其风险和益处,而且还需要扩大为临床实践提供依据的证据基础。结论在没有关于剂量,相互作用和其他特征的正式临床指南的情况下,建议医学上使用大麻的人似乎是在自我形成社区实践标准。需要减少对大麻产品进行临床研究的障碍,这不仅是为了更好地了解其风险和益处,而且还需要扩大为临床实践提供依据的证据基础。结论在没有关于剂量,相互作用和其他特征的正式临床指南的情况下,建议医学上使用大麻的人似乎是在自我形成社区实践标准。需要减少对大麻产品进行临床研究的障碍,这不仅是为了更好地了解其风险和益处,而且还需要扩大为临床实践提供依据的证据基础。
更新日期:2019-12-14
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