Medical cannabis: Four patient perspectives
Abstract
The use medical cannabis has been increasing in recent years. This paper provides the perspectives of four patients with very different clinical backgrounds and their reported experiences using medical cannabis. Not all patients respond the same way to cannabis and effective use requires a degree of experimentation as these patients’ perspectives illustrate. In these perspectives, it is important to note the reported effective management of specific symptoms, but also of importance is the reported improvement in general well-being and vast improvement in reported quality of life.
... La medicina, como una ciencia basada en evidencia, ha estado abordando el tema del UMC con mucha cautela debido a la falta de datos clínicos suficientes y de apoyo (Tellioğlu & Tellioğlu, 2017;Friedberg, 2017;O'Hearn et al., 2017;Cheung & Clarke, 2017). ...
... Ademas, se refiere en la evidencia que el UMC en la adolescencia puede provocar una serie de síntomas físicos, tiene una fuerte asociación con la esquizofrenia, puede afectar el desarrollo neurocognitivo en el cerebro de un adolescente que no está completamente maduro y puede llevar a problemas escolares, de relación y de trabajo, así como a accidentes automovilísticos. Además, no todos los pacientes adolescentes responden de la misma manera al UMC (Compton et al., 2017;Friedberg, 2017). ...
Resumen Este estudio pretende reportar la evidencia actual sobre el uso medicinal de cannabis existente en la base de datos Scopus. Se llevó a cabo una revisión sistemática de las publicaciones científicas, entre el periodo 2013-2017, disponibles en Scopus sobre el uso medicinal de cannabis. Estados Unidos es el país con mayor cantidad de publicaciones, seguido de Canadá e Israel; existiendo un aumento progresivo y constante de la evidencia entre los años 2013 y 2017. Los contenidos de las publicaciones versan sobre efectos beneficiosos y adversos para la salud, consecuencias de la legislación del cannabis y su asociación con diversas variables. Existe una falta de estudios en uso medicinal de cannabis respecto a tratamientos y enfermedades, su estandarización, vías de administración y dosis, dando cuenta de la necesidad de un volumen mayor de investigaciones al respecto.
Context
Studies generally focus on one type of chronic condition and the effect of medical cannabis (MC) on symptoms; little is known about the perceptions and engagement of patients living with chronic conditions regarding the use of MC.
Objectives
This scoping review aims to explore: (1) what are the dimensions addressed in studies on MC that deal with patients' perceptions of MC? and (2) how have patients been engaged in developing these studies and their methodologies? Through these objectives, we have identified areas for improving future research.
Methods
We searched five databases and applied exclusion criteria to select relevant articles. A thematic analysis approach was used to identify the main themes: (1) reasons to use, to stop using or not to use MC, (2) effects of MC on patients themselves and empowerment, (3) perspective and knowledge about MC, and (4) discussion with relatives and healthcare professionals.
Results
Of 53 articles, the main interest when assessing the perceptions of MC is to identify the reasons to use MC (n = 39), while few articles focused on the reasons leading to stop using MC (n = 13). The majority (85%) appraise the effects of MC as perceived by patients. Less than one third assessed patients’ sense of empowerment. Articles determining the beliefs surrounding and knowledge of MC (n = 41) generally addressed the concerns about or the comfort level with respect to using MC. Only six articles assessed patients’ stereotypes regarding cannabis. Concerns about stigma constituted the main topic while assessing relationships with relatives. Some articles included patients in the research, but none of them had co-created the data collection tool with patients.
Conclusions
Our review outlined that few studies considered chronic diseases as a whole and that few patients are involved in the co-construction of data collection tools as well. There is an evidence gap concerning the results in terms of methodological quality when engaging patients in their design. Future research should evaluate why cannabis’ effectiveness varies between patients, and how access affects the decision to use or not to use MC, particularly regarding the relationship between patients and healthcare providers. Future research should consider age and gender while assessing perceptions and should take into consideration the legislation status of cannabis as these factors could in fact shape perception. To reduce stigma and stereotypes about MC users, better quality and accessible information on MC should be disseminated.
A Cannabis sativa L., planta popularmente conhecida por canabis ou maconha, apresenta uma história relacionada a diversos impactos socioculturais, consequência de seus diversos usos possíveis, dentre eles, o uso medicinal. Ainda que seja uma “erva proibida” em muitos lugares do mundo, a espécie tem despertado interesse da comunidade científica e da indústria farmacêutica, além de gerar expectativas em muitas pessoas. Diante desse cenário, o objetivo desse estudo foi revelar a experiência dos pacientes com o uso medicinal da Cannabis, por meio de uma revisão integrativa de artigos qualitativos primários. Os três temas mais recorrentes, em ordem descrescente, foram “Benefícios do uso”, “Desafios enfrentados” e “Padrões de uso contemporâneos”. Os subtemas mais citados no primeiro tema mencionado foram “Eficácia percebida” e “Menos efeitos indesejados e menores quantidades de medicamentos”. Já no segundo tema mencionado, o subtema mais expressivo foi “Desaprovação médica e receio em conversar com profissionais de saúde”. Por fim, em relação ao terceiro tema mencionado, o subtema “Métodos variados de uso” foi o mais recorrente. Espera-se que os resultados obtidos nessa revisão sirvam de instrumento para os profissionais de saúde no planejamento de estratégias para ensino, pesquisa e práticas com perspectivas ampliadas e informadas sobre o uso da Cannabis Medicinal no processo de cuidado.
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