Physician knowledge and attitudes towards cannabis impact allergy treatment


Zeiger reports that he is the CEO of the Canna Research Foundation and receives funding from ACCAI, CSACI, EAACI and Allergists for Israel. Please see the study for relevant financial information from all other authors.

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According to a study published in Annals of Allergy, Asthma and Immunology.

“It has been shown in the literature that doctors’ knowledge of cannabis is lacking. Until recently, there was no way to learn more about cannabis», Joanna S. Zeiger, MS, PhD, CEO of the Canna Research Foundation, told Healio.

Data are from Zeiger JS, et al. Ann Allergy Asthma Immunol. 2022; doi:10.116/j.anai.2022.04.021.

Joanna S. Zeiger

“We wanted to identify knowledge gaps and determine what kind of knowledge system would be of interest to allergists,” Zeiger said.

Previous work by the researchers found that 18% of people with allergies and asthma had used cannabis in the previous 2 weeks, and more than 50% of them had used it by inhalation.

“This could potentially exacerbate asthma symptoms of coughing and wheezing in asthmatics, especially if their asthma is not well controlled,” Zeiger said.

Many of these respondents reported beneficial effects on sleep, pain and anxiety related to cannabis use, Zeiger continued. Only 19% of these patients wanted to discuss cannabis with their doctor, while only 34% of doctors asked questions about cannabis use.

“We wanted to understand whether knowledge and attitudes about cannabis influenced doctors’ comfort in talking to patients about cannabis, whether they advised them to stop inhaling cannabis, whether they asked patients how often they used cannabis and their preferred route of administration,” Zeiger said.

As part of the Cannabis Allergy KAP (Knowledge, Attitudes, Practice) collaboration, researchers surveyed 207 members of the American College of Allergy, Asthma and Immunology, 47 members of the Canadian Society of Allergy and Clinical Immunology ( CSACI) and 191 members of the European Academy of Allergy and Clinical Immunology (EAACI).

The cohort was made up of 49.7% women, 65.2% of whom were born between 1946 and 1964. In addition, 54.4% had less than 20 years of experience, 54.9% worked in non-university settings or research and 93.1% had an MD, MD, or MD. degrees in Philosophy.

The survey included seven items on cannabis knowledge related to allergy care, 13 items on attitudes towards cannabis, and four questions on approaches to cannabis practice.

According to the survey, 51.2% of respondents had received patient complaints of cannabis allergy, with the highest percentage being 74.5% of CSACI members and the lowest percentage being 36.2%. ACAAI members (P

In addition, 84.5% of respondents had seen between one and nine patients with suspected cannabis allergy, with symptoms such as urticaria/angioedema (27.1%), nasal congestion (24.6% ), rhinitis (23.2%), cough (23%) and anaphylaxis. (14.9%).

Cannabis sensitization skin tests were performed by 71.4% of CSACI members, 35.4% of EAACI members, and 25.3% of ACAAI members. Additionally, only 5.3% performed in vitro testing for cannabis sensitization.

On a scale of 0 to 7, with 0 indicating no correct answer and 7 indicating all correct answers, the researchers found an overall average of 3 (standard deviation [SD], 1.7) for knowledge. ACAAI respondents had an average of 3.5 (SD, 1.6), CSACI respondents had an average of 3.3 (SD, 1.6) and EAACI respondents had an average of 2.4 (SD, 1 ,6).

The analysis also led the researchers to classify attitudes towards cannabis as traditional (n=138; 31%), progressive (n=215; 48.3%) or uncertain (n=92; 20.7%). ACAAI respondents included 22.7% traditional, 60.4% progressive, and 16.9% uncertain. CSACI respondents included 10.6% traditional, 66% progressive and 23.4% uncertain. EAACI respondents included 45% traditional, 30.9% progressive and 24.1% uncertain.

Overall, 70.1% of respondents said they were comfortable talking to patients about cannabis, including 67.6% for the ACAAI, 76.6% for the CSACI and 66% for the EAACI, but only 35.5% reported verbally asking patients about cannabis use or doing so. on their admission form.

Similarly, only 28.9% had verbally asked patients about cannabis use in the previous month, although 46.2% said they had noticed an increase in cannabis use among their patients. Questions were most often about how often and how patients used it (56.8% and 51.2%, respectively).

When patients indicated that they smoked or vaporized cannabis, 30.9% of physicians said they always advised quitting and 29.1% said they sometimes advised quitting.

Additionally, there were differences in the discussion of cannabis by the three allergy societies, as 28.6% of EAACI members, 13.5% of ACAAI members, and 4.3% of of the CSACI did not discuss cannabis with their patients.

Physicians who were more knowledgeable about cannabis were more likely to be comfortable discussing it with their patients, asking patients how and how often it was used, and counseling patients about quitting (P

However, physicians categorized as having uncertain attitudes toward cannabis were less comfortable talking to patients about it, while those with progressive attitudes were the most comfortable (P

Knowledge and attitudes can replace demographics, location and legality in the approach to care, the researchers said, adding that knowledge impacts attitudes, which then impact care.

“We found that allergists who were more knowledgeable about cannabis tended to have more progressive attitudes toward cannabis, which led to more comfort in talking to patients about cannabis and asking patients what how often they consumed cannabis and what method of consumption they used,” Zeiger mentioned.

Conversely, physicians with uncertain attitudes had the lowest knowledge and were the least likely to discuss cannabis with their patients. Researchers indicated that a lack of education about cannabis and the endocannabinoid system is one of the most common barriers to patient knowledge and willingness to consult.

“Patients with all types of conditions use cannabis. Thus, it is important that physicians educate themselves about cannabis so that they can ask their patients the right questions, verbally or on intake forms – or both – about their cannabis use and discuss cannabis without judgment. said Zeiger.

While cannabis can be beneficial in many situations, it also has adverse effects, Zeiger warned. Patients need to be educated by trusted sources to maximize the positive effects of cannabis while minimizing its harms, she continued, and they seek guidance.

“Currently, cannabinoid dosage, frequency of use, and ratios are difficult to address because little research has been done, and these parameters likely differ depending on the symptoms/conditions being treated,” Zeiger said.

Researchers have used professional companies to create cannabis content that provides general information focused on their specialty. Additionally, according to the researchers, physicians need to understand the laws regarding cannabis use where they practice.

The survey indicates that 48.5% of allergists want didactic learning, 46.7% would like pro/con learning and 41.1% said the modules would meet their needs, with 68.8% preferring webinars and 56 .4% favoring national meetings.

“The more doctors engaged in this type of discourse, the better, because it will help build the knowledge base in a real-world setting,” Zeiger said.

“Physicians can help de-stigmatize cannabis and make it easier for those who need it for medical purposes and perhaps even exert influence to make cannabis federally legal, which will make the study of cannabis much more more doable,” she said.

The researchers plan to continue similar surveys with other groups of physicians and patients.

“Additionally, we will be creating educational materials to help allergists learn about many facets of cannabis to help them in their interactions with patients regarding cannabis,” Zeiger said.

“The more doctors know about cannabis, the more likely they are to discuss it with patients, and that leads to a safer and potentially more effective situation for cannabis use.”

For more information:

Joanna S. Zeiger, MS, PhD, can be reached at [email protected]

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