In a recent survey of neurologists, nurse practitioners (NPs)/nurses, and pharmacists, over 80% of clinicians reported generally favorable attitudes about the use and legalization of medical cannabis, especially cannabidiol (CBD) for the treatment of epilepsy. However, over 40% of these clinicians also reported knowledge gaps in prescribing CBD therapies. Full study results are published in Epilepsy and Behavior.
The survey was sent between August and September 2018 to examine attitudes and knowledge regarding cannabis for medical and recreational purposes. The survey consisted of 29 structured items that focused on CBD therapies, medical cannabis, and recreational cannabis.
Attitudes regarding cannabis were assessed by the perceived effectiveness of CBD/medical cannabis, regulation and availability of products, and stigma associated with recommending CBD treatment. Knowledge of the endocannabinoid system, pharmacology, effects, clinical applications, and government regulation of cannabis was also assessed. Workplace was categorized by community hospital, academic hospital, private practice, or other.
An additional variable to the survey asked if the provider practiced in a state where medical cannabis was legalized, a state that had limited access to medical cannabis or could be prescribed for specific conditions only, a state that had legalized any adult cannabis use, or a state where any cannabis use was illegal.
A total of 451 clinicians completed the survey and met inclusion criteria: 53% were women, 83% white, and 4% Hispanic/Latinx. Professional tenure was reported among 65% of respondents: 24% worked in academic hospitals, 11% in pediatric practices, and 45% in places that did not permit medical cannabis use. Over half of respondents (58%) resided in states with comprehensive marijuana laws.
Results of the study indicated generally favorable attitudes but mixed levels of knowledge about CBD/medical cannabis. Over 80% of providers favored the federal government and states legalizing medical cannabis, especially CBD for epilepsy when prescribed by a medical provider. Forty-three percent supported legalization of recreational cannabis. A total of 20% to 44% of respondents (depending on the question) considered themselves not knowledgeable about CBD/medical cannabis or were unfamiliar with issues related to regulation and availability of products. The survey found gaps in knowledge: 26% to 68% answered incorrectly or did not know the answer to a particular question.
Nurse practitioners/nurses scored higher on attitudes about medical cannabis than neurologists and pharmacists, and NPs/nurses and neurologists had higher perceived knowledge than pharmacists. However, pharmacists scored higher on the actual knowledge test than did neurologists and NPs/nurses. A total of 74% of neurologists, 88% of nurses, and 92% of NPs agreed that there is a stigma associated with recommending medical cannabis.
Continuing medical education (CME), webinars, and lectures were the top choices for education on cannabis/medical cannabis; however, NPs/nurses (combined), NPs (alone), and pharmacists preferred webinar over CME.
“Properly educated [healthcare providers] can weigh potential benefits/risks of medical cannabis for individual patients and help mitigate potentially unsafe practices,” concluded the researchers. “Thus, professional cannabinoid education nationwide is immensely needed.”
Szaflarski M, McGoldrick P, Currens L, et al. Attitudes and knowledge about cannabis and cannabis-based therapies among US neurologists, nurses, and pharmacists [published online May 19, 2020]. Epilepsy Behav. doi: 10.1016/j.yebeh.2020.107102.