Health professional beliefs, knowledge, and concerns surrounding medicinal cannabis – A systematic review

Abstract

Background The number of jurisdictions allowing access to medicinal cannabis has been steadily increasing since the state of California introduced legislation in 1996. Although there is a high degree of legislative heterogeneity across jurisdictions, the involvement of a health professional is common among all. This places health professionals at the forefront of therapy, yet no systematic review of literature has offered insight into the beliefs, knowledge, and concerns of health professionals regarding medicinal cannabis. Methods Using a predetermined study protocol, PubMed, EMBASE, PsycINFO, CINAHL, and Scopus databases were searched for studies indexed up to the 1 st August 2018. Pre-defined inclusion and exclusion criteria were applied uniformly. Screening for relevancy, full-text review, data extraction, and risk of bias were completed by two independent investigators. Risk of bias was assessed using CASP criteria (qualitative) and a modified domain-based risk assessment tool (quantitative). Results Of the 15,775 studies retrieved, 106 underwent full-text review and of these, 26 were included. The overall risk of bias was considered low across all included studies. The general impression was that health professionals supported the use of medicinal cannabis in practice; however, there was a unanimous lack of self-perceived knowledge surrounding all aspects of medicinal cannabis. Health professionals also voiced concern regarding direct patient harms and indirect societal harms. Conclusion This systematic review has offered a lens through which to view the existing literature surrounding the beliefs, knowledge, and concerns of health professionals regarding medicinal cannabis. These results are limited, however, by the implicit common-sense models of behaviour utilised by the included studies. Before strategies can be developed and implemented to change health professional behaviour, a more thorough understanding of the factors that underpin the delivery of medicinal cannabis is necessary.

Cannabis: An Emerging Treatment for Common Symptoms in Older Adults

“…Under half of current users reported telling their healthcare providers about their cannabis use. Past research has shown clinicians, for the most part, are supportive of cannabis for medical use, but they have reservations about the limited evidence base, potential safety issues, and product quality and effectiveness 32,33 . A study by Baumbusch et al found older adult cannabis users discussed cannabis with their healthcare providers; however, the main source of information they received was from nonclinical sources (e.g., friends and media) 34 .…”

The effect of attitudes, subjective norms and stigma on health‐care providers' intention to recommend medicinal cannabis to patients

“…Among nurse practitioners in Canada, 57% reported that they would be comfortable authorizing MC, with this number increasing to 64% if they were to receive an appropriate evidence‐based education (Balneaves et al, 2018). A recent systematic review highlighted that although the general impression is that health professionals support the use of MC in practice, they reported a lack of self‐perceived knowledge surrounding MC and voiced concerns regarding direct patient harm and indirect societal harm (Gardiner, Singleton, Sheridan, Kyle, & Nissen, 2019). No examination of the factors affecting the intention of Israeli nurses and physicians to recommend MC for patients with qualifying conditions has been conducted so far.…”

Medical cannabis: What practitioners need to know

“…Few healthcare practitioners are equipped with knowledge of the evidence, indications and legislation to support the safe use of medical cannabis. [4] In this overview, we summarise the indications for the clinical administration of medical cannabis, how practitioners may access medical cannabis and the current published evidence base. We emphasise that unregulated and unregistered cannabis products sold as medical cannabis may be of inadequate quality and unverified composition, and are not guaranteed to be safe or effective.…”