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Cited by 10Cannabis and Cannabinoid ResearchOpioid Use Disorder TreatmentPain Management and Opioid Use

Prevalence and determinants of cannabinoid prescription for the management of chronic noncancer pain: a postal survey of physicians in the Abitibi-Temiscamingue region of Quebec

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St-Amant, H., Ware, M. A., Julien, N., Lacasse, A.·2015·CMAJ Open
DOI 10.9778/cmajo.20140095PMC PMC4565172
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Abstract

BACKGROUND: Few studies have been conducted to explore physicians' prescription practices and attitudes toward the use of cannabinoids in Canada.We measured the prevalence and identified determinants of cannabinoid prescription for the management of chronic noncancer pain among physicians in southwestern Quebec. METHODS: In February 2013, we conducted a postal survey using a modified Dillman method that involved physicians practising in the Abitibi-Témiscamingue region of Quebec. We used multivariate logistic regression models to identify determinants of cannabinoid prescription. RESULTS: A total of 166 physicians of 318 practising in the region participated in the survey (response rate 52.2%). The prevalence of cannabinoid prescription was 27.3% (45/165) for any indication and 23.0% (38/165) for the management of chronic noncancer pain; 91.1% (41/45) of the physicians prescribed cannabinoids to 5 or fewer patients. Of the 38 physicians who prescribed cannabinoids for chronic noncancer pain, 35 (92.1%) prescribed nabilone, 7 (18.4%) medical marijuana and 2 (5.3%) nabiximols. The principal determinant of cannabinoid prescription was the physician's level of comfort with prescribing cannabinoids (adjusted odds ratio 1.25, 95% confidence interval 1.01-1.55, per 1-point increase in comfort level measured on 10-point scale). Respondents reported that continuing medical education (CME) activities could increase their comfort level. They also indicated a need for guidelines or algorithms that included cannabinoid use as well as more studies about the efficacy and safety of cannabinoids for the management of chronic noncancer pain. INTERPRETATION: We found that cannabinoids were not often prescribed for the management of chronic noncancer pain and that survey respondents were not comfortable with prescribing this drug class. This degree of discomfort could be addressed by CME activities, more effective dissemination of guidelines and more evidence regarding cannabinoid use for the management of chronic noncancer pain.

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Research works printed but not linked: 4

  1. [11]11. Bonfá L, Vinagre RC, de Figueiredo NV. Cannabinoids in chronic pain and palliative care. Rev Bras Anestesiol 2008;58:267-79.
  2. [22]22. Ste-Marie PA, Fitzcharles MA. Cannabinoid use in fibromyalgia is associated with male gender, opioid use and drug seeking behaviour. Pain Res Manag 2012;17:224.
  3. [26]26. Ziemianski D, Tekanoff R, Luconi F, et al. Cannabinoids in clinical practice: experiences and educational needs. Pain Res Manag 2012;17:229.
  4. [27]27. Dillman DA. Mail and telephone surveys. New York: Wiley Interscience; 1978.

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Authors
St-Amant, H., Ware, M. A., Julien, N., & Lacasse, A.
Affiliations
  • Université du Québec en Abitibi-Témiscamingue (CA)
  • McGill University Health Centre (CA)
ORCID
Venue
CMAJ Open
Publisher
CMA Joule Inc.
Published
2015-07-02
Volume
3
Issue
2
Pages
E251-E257
ISSN
2291-0026 (ISSN-L)
DOI
10.9778/cmajo.20140095
PMC
PMC4565172
OpenAlex
W2255307096
Cited by
10
References
42
Citations by year
2023: 1 · 2021: 3 · 2020: 1 · 2018: 3 · 2016: 2
FWCI
1.20
Type
journal article
Language
en
Open access
Locations
  • CMAJ Open (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Canadian Pain Society
  • Réseau québécois de recherche sur la douleur
Topics
  • Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
chronic non-cancer pain, physician prescribing, physician attitudes, nabilone, nabiximols, medical cannabis, continuing medical education, Abitibi-Témiscamingue

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