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Medical cannabis

Pharmacists lack knowledge and confidence around cannabis, study finds

Of three studies sampling pharmacists’ beliefs, knowledge and concerns about medical cannabis, researchers found that self-reported knowledge and confidence was low.

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A Canadian study found that just over half of hospital pharmacists agreed that, overall, medical cannabis was effective, although, their self-reported knowledge was quite low

Pharmacists support the use of medical cannabis in practice but have concerns about the potential harms it may cause to patients, study results show.

Researchers carried out a systematic review of 26 studies that looked at the beliefs, knowledge, and concerns of healthcare professionals surrounding the delivery of cannabis. The studies were carried out in the United States, Canada, Australia, Israel and Ireland. They sampled a range of healthcare professionals, including doctors, nurses, and pharmacists.

Of the three studies sampling pharmacists, based in Canada, the United States and Australia, the Canadian study found that just over half of hospital pharmacists agreed that, overall, medical cannabis was effective. Across all three studies, however, self-reported knowledge was quite low.

In the US study, pharmacists considered themselves to be lacking knowledge surrounding the pharmacology, pharmacokinetics and pharmacodynamics of medical cannabis.

In the United States and Canadian studies, pharmacists also said that legislative and procedural knowledge around prescribing, cultivation and distribution was inadequate.

In the Canadian study, pharmacists said a lack of accessible and robust literature was a major limitation when faced with clinical questions, and just under 70% of pharmacists said that they used self-directed online learning to inform their practice.

Among the concerns reported by pharmacists was the potential for recreational misuse, the possibility for diversion into illicit channels and the risk of drug–drug interactions.

In the Canadian study, 55% of hospital pharmacists said they either disagreed that medical cannabis was safe or were unsure and, in another, the same proportion said they felt uncomfortable with the potential link between medical cannabis and psychiatric illness.

The review’s authors concluded that although healthcare professionals were relatively supportive of medical cannabis in clinic practice, their support was often “counterbalanced” by a lack of confidence, competence and concerns for the associated risks.

Lead author Kyle Gardiner, from the School of Clinical Sciences, Queensland University of Technology in Brisbane, Australia, said: “In almost all international jurisdictions, the involvement of at least one health professional is required for patients to acquire medicinal cannabis … so, clinicians are in the crosshairs and we need to understand their behaviours and engagement.

“It is important to know their attitudes and concerns about the delivery and use of medicinal cannabis, what knowledge they have, and where they are getting their information. However, these are a few pieces of a much larger picture.”

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206519

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