TY - JOUR
T1 - A qualitative study of VHA clinicians' knowledge and perspectives on cannabis for medical purposes
AU - Christensena, Vivian A.
AU - Nugent, Shannon M.
AU - Ayers, Chelsea K.
AU - Morasco, Benjamin J.
AU - Kansagara, Devan
N1 - Funding Information:
Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development, Evidence Synthesis Program (ESP) (project no. 05-225 to DK). Ethical approval: VA Portland Healthcare System Institutional Review Board (IRB).
Publisher Copyright:
© 2021 Published by Oxford University Press.
PY - 2021/8/1
Y1 - 2021/8/1
N2 - Background: The legalization of cannabis is expanding across the USA, and its use has increased significantly, including among Veterans. Although the Veterans Health Administration (VHA) abides by the classification of cannabis as a Schedule I substance, it recently recommended that clinicians discuss cannabis with their patients. Little is known about VHA clinicians' perspectives on and knowledge of cannabis. Objective: We sought to better understand clinicians' attitudes, beliefs, knowledge and communication with patients regarding cannabis. Methods: We conducted semi-structured phone interviews with 14 VHA clinicians. Interviews were audio-recorded, transcribed verbatim and analysed using qualitative thematic analysis. Results: VA clinicians described ambivalence towards cannabis for therapeutic purposes and identified several factors that inhibit conversations about cannabis use with their patients including discomfort with the lack of product standardization; lack of research examining the effectiveness and risks of cannabis use; unfamiliarity with pharmacology, formulations, and dosing of cannabis; and uncertainty regarding VHA policy. Clinicians had differing views on cannabis in the context of the opioid crisis. Conclusions: VA clinicians face challenges in navigating the topic of medical cannabis. Educational materials about cannabis products, dose and harms would be helpful to clinicians.
AB - Background: The legalization of cannabis is expanding across the USA, and its use has increased significantly, including among Veterans. Although the Veterans Health Administration (VHA) abides by the classification of cannabis as a Schedule I substance, it recently recommended that clinicians discuss cannabis with their patients. Little is known about VHA clinicians' perspectives on and knowledge of cannabis. Objective: We sought to better understand clinicians' attitudes, beliefs, knowledge and communication with patients regarding cannabis. Methods: We conducted semi-structured phone interviews with 14 VHA clinicians. Interviews were audio-recorded, transcribed verbatim and analysed using qualitative thematic analysis. Results: VA clinicians described ambivalence towards cannabis for therapeutic purposes and identified several factors that inhibit conversations about cannabis use with their patients including discomfort with the lack of product standardization; lack of research examining the effectiveness and risks of cannabis use; unfamiliarity with pharmacology, formulations, and dosing of cannabis; and uncertainty regarding VHA policy. Clinicians had differing views on cannabis in the context of the opioid crisis. Conclusions: VA clinicians face challenges in navigating the topic of medical cannabis. Educational materials about cannabis products, dose and harms would be helpful to clinicians.
KW - Doctor-patient relationship
KW - Veteran's health
KW - health risk behaviours
KW - marijuana use
KW - physician competency
KW - qualitative methods
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U2 - 10.1093/fampra/cmaa151
DO - 10.1093/fampra/cmaa151
M3 - Article
C2 - 33558870
AN - SCOPUS:85112589429
SN - 0263-2136
VL - 38
SP - 479
EP - 483
JO - Family Practice
JF - Family Practice
IS - 4
ER -