Preliminary Study of Chronic Pain Patients' Concerns About Cannabinoids as Analgesics

Gill, Amritpal; Williams, Amanda C de C

doi:10.1097/00002508-200109000-00010

Cited by 8 publications

(8 citation statements)

References 16 publications

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“…Most patients with advanced life-limiting illnesses were comfortable using cannabis for pain, 25 while some other patients with chronic pain were unwilling or ambivalent about medical cannabis use. 26 Non-white patients with advanced illness were more concerned about medical cannabis compared with white patients, but they remained comfortable using medical cannabis. 25 People living with chronic pain who used medical cannabis believed it was effective for reducing their pain 25 27 31 34 and allowed them to reduce use of prescribed medications.…”

Section: Resultsmentioning

confidence: 99%

Values and preferences towards medical cannabis among people living with chronic pain: a mixed-methods systematic review

et al. 2021

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ObjectiveTo explore values and preferences towards medical cannabis among people living with chronic pain.DesignMixed-methods systematic review.Data sourcesWe searched MEDLINE, EMBASE and PsycINFO from inception to 17 March 2020.Study selectionPairs of reviewers independently screened search results and included quantitative, qualitative and mixed-methods studies reporting values and preferences towards medical cannabis among people living with chronic pain.Review methodsWe analysed data using meta-narrative synthesis (quantitative findings were qualitised) and tabulated review findings according to identified themes. We used the Grading of Recommendations Assessment, Development and Evaluation approach to assess certainty of evidence.ResultsOf 1838 initial records, 15 studies proved eligible for review. High to moderate certainty evidence showed that patient’s use of medical cannabis for chronic pain was influenced by both positive (eg, support from friends and family) and negative social factors (eg, stigma surrounding cannabis use). Most patients using medical cannabis favoured products with balanced ratios of tetrahydrocannabinol (THC) and cannabidiol (CBD), or high levels of CBD, but not high THC preparations. Many valued the effectiveness of medical cannabis for symptom management even when experiencing adverse events related to concentration, memory or fatigue. Reducing use of prescription medication was a motivating factor for use of medical cannabis, and concerns regarding addiction, losing control or acting strangely were disincentives. Out-of-pocket costs were a barrier, whereas legalisation of medical cannabis improved access and incentivised use.Low to very low certainty evidence suggested highly variable values towards medical cannabis among people living with chronic pain. Individuals with pain related to life-limiting disease were more willing to use medical cannabis, and preferred oral over inhaled administration.ConclusionsOur findings highlight factors that clinicians should consider when discussing medical cannabis. The variability of patients’ values and preferences emphasise the need for shared decision making when considering medical cannabis for chronic pain.

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Section: Resultsmentioning

confidence: 99%

Values and preferences towards medical cannabis among people living with chronic pain: a mixed-methods systematic review

et al. 2021

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“…Thirteen studies were excluded because they did not include a measure of medication adherence [72]–[85]. Two of these included separate assessment modes for intentional and unintentional adherence but no overall adherence assessment [80], [85].…”

Section: Resultsmentioning

confidence: 99%

Understanding Patients’ Adherence-Related Beliefs about Medicines Prescribed for Long-Term Conditions: A Meta-Analytic Review of the Necessity-Concerns Framework

Horne¹,

Chapman²,

Parham³

et al. 2013

PLoS ONE

897

888

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BackgroundPatients’ beliefs about treatment influence treatment engagement and adherence. The Necessity-Concerns Framework postulates that adherence is influenced by implicit judgements of personal need for the treatment (necessity beliefs) and concerns about the potential adverse consequences of taking it.ObjectiveTo assess the utility of the NCF in explaining nonadherence to prescribed medicines.Data sourcesWe searched EMBASE, Medline, PsycInfo, CDSR/DARE/CCT and CINAHL from January 1999 to April 2013 and handsearched reference sections from relevant articles.Study eligibility criteriaStudies using the Beliefs about Medicines Questionnaire (BMQ) to examine perceptions of personal necessity for medication and concerns about potential adverse effects, in relation to a measure of adherence to medication.ParticipantsPatients with long-term conditions.Study appraisal and synthesis methodsSystematic review and meta-analysis of methodological quality was assessed by two independent reviewers. We pooled odds ratios for adherence using random effects models.ResultsWe identified 3777 studies, of which 94 (N = 25,072) fulfilled the inclusion criteria. Across studies, higher adherence was associated with stronger perceptions of necessity of treatment, OR = 1.742, 95% CI [1.569, 1.934], p<0.0001, and fewer Concerns about treatment, OR = 0.504, 95% CI: [0.450, 0.564], p<0.0001. These relationships remained significant when data were stratified by study size, the country in which the research was conducted and the type of adherence measure used.LimitationsFew prospective longitudinal studies using objective adherence measures were identified.ConclusionsThe Necessity-Concerns Framework is a useful conceptual model for understanding patients’ perspectives on prescribed medicines. Taking account of patients’ necessity beliefs and concerns could enhance the quality of prescribing by helping clinicians to engage patients in treatment decisions and support optimal adherence to appropriate prescriptions.

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“…One such barrier to the use of lenabasum includes the possibility of patient apprehension at the use of cannabinoids . Despite the relaxation of laws globally regarding the medicinal use of cannabinoids, their widespread adoption is not assured.…”

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confidence: 99%

“…Despite the relaxation of laws globally regarding the medicinal use of cannabinoids, their widespread adoption is not assured. Experience in oncology has illustrated that patient acceptance is related to severity of disease, previous recreational use and lack of efficacy of previous medications . One could hypothesize with regards to DM, that cannabinoid derivates may therefore only be highly acceptable to those with severe, treatment‐resistant disease and less likely to be acceptable in paediatric cohorts.…”

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confidence: 99%

New therapeutics for itch in dermatomyositis

Frew

2018

Br J Dermatol

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Preliminary Study of Chronic Pain Patients' Concerns About Cannabinoids as Analgesics

Abstract: The concerns of patients with chronic pain about taking cannabinoids as analgesics may reduce their utility and efficacy; accurate information is required to counter this effect.

Cited by 8 publications

References 16 publications

Values and preferences towards medical cannabis among people living with chronic pain: a mixed-methods systematic review

Values and preferences towards medical cannabis among people living with chronic pain: a mixed-methods systematic review

Understanding Patients’ Adherence-Related Beliefs about Medicines Prescribed for Long-Term Conditions: A Meta-Analytic Review of the Necessity-Concerns Framework

New therapeutics for itch in dermatomyositis

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