A National Needs Assessment of Canadian Nurse Practitioners Regarding Cannabis for Therapeutic Purposes

Abstract

Introduction: In Canada, the Access to Cannabis for Medical Purposes Regulations (ACMPR) has given nurse practitioners (NPs) the power to authorize cannabis for therapeutic purposes (CTP) to eligible patients. This expansion in NPs' scope of practice underscores the importance of delivering balanced, evidence-based education on cannabis to NPs. The aim of this national study was to assess NPs' knowledge and practice gaps related to CTP to inform the development of future education resources that increase NPs' clinical competence and improve patient care related to medical cannabis.Methods: This is a quantitative, descriptive exploratory design study. A national online survey of NPs was conducted from August 2013 to June 2014. NPs were recruited through email lists held by numerous Canadian nursing organizations. The survey was adapted from a previous national survey that assessed CTP educational needs among Canadian physicians. The survey assessed NPs' knowledge, experience, barriers, and attitudes related to CTP as well as preferred format for future CTP education.Results: The sample consisted of 182 NPs from across Canada. The largest knowledge gap was related to dosing and creating effective treatment plans for patients using CTP. The majority of respondents (76.3%) ranked the need for education on CTP to be either strong or very strong. Over half (57%) reported that they would be comfortable authorizing medical cannabis through the ACMPR; this number increased to 64% if they were to receive appropriate education.Conclusion: Nursing regulatory organizations, in partnership with academic institutions and government agencies, must work toward the development of educational and clinical competencies specific to CTP. Tailored education programs are needed to address the knowledge gaps held by NPs and the clinical barriers they face to including CTP as part of their care.

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

“…[21–46] A flow diagram of study selection is shown in Fig 1. Of the 26 studies included, 13 were conducted in the United States (US),[22, 25–28, 30, 33, 37, 38, 40–43] four were conducted in Canada,[23, 32, 39, 45] three were conducted in Australia[34–36] and Israel,[21, 31, 46] two were conducted in Ireland,[29, 44] and one covered an international sample. [24] There were 18 studies that sampled medical practitioners,[21, 24–26, 28–32, 34, 36, 37, 40–42, 44–46] and three studies that sampled pharmacists.…”

“…[33, 35, 39] An additional five studies included in this review were grouped according to the high proportion of nursing professionals sampled. [22, 23, 27, 38, 43] One study sampled exclusively nurse practitioners[23] while the other four studies sampled a mixed cohort of medical and allied health professionals of which nurses were the predominant population. [22, 27, 38, 43] Altogether, these five studies had a pooled sample of 1,584 participants including 847 (53%) registered nurses and nurse practitioners, 495 (31%) medical practitioners, 118 (8%) pharmacists, 37 (2%) social workers, 21 (1.5%) physician assistants, and three (0.5%) osteopathic physicians.…”

“…Conditional to the survey questions, these five studies reported: (a) a willingness to help children with cancer access medicinal cannabis[22], (b) ‘turning a blind eye’ to the unlawful use of medicinal cannabis because of a belief in its benefits[43], (c) the belief that medicinal cannabis is useful for chronic conditions[27], (d) support for the clinical utility of medicinal cannabis[38] and (e) comfort supporting a patient’s right to access medicinal cannabis. [23]…”

Nausea and Vomiting Not Related to Cancer Therapy: Intractable Problem or Clinical Challenge?

“…Even if MC remains illegal at the national level, APs need to help patients make decisions about how to use it (e.g., smoking, vaping, edibles), possible side effects (especially impaired motor function, increasing the risk for vehicle accidents), associated costs for MC cards and cannabis products, potential drug interactions with MC, and so forth. A recent survey of Canadian NPs (who had recently been legislated MC prescriptive authority) is instructive ( Balneaves, Alraja, Ziemianski, McCuaig, & Ware, 2018 ). Almost 80% agreed NPs should be authorized to approve MC, but responded that knowledge gaps, lack of clinical guidelines, and inadequate information about appropriate use were major barriers to use.…”

Cannabinoids in Pain Treatment: An Overview

“…With the necessity for more patient-centered outcomes research, nurse researchers can design and implement studies within real-life daily practice that have practical implications for clinical practice (Newhouse, Barksdale, & Miller, 2015). Study designs focusing on needs assessment have been performed in Canada to assess the knowledge of advance practice nurses' knowledge and competence surrounding the use of medical cannabis (Balneaves, et al, 2018). These studies will need replication and validation in the United States, as the use of medicinal and recreation cannabis continues to grow.…”