Decision-Making Experiences to use Medicinal Cannabis: Perspectives from Patients with Knee Osteoarthritis and Their Care Providers.

Authors

  • Wijitra Sena Community Health Development Program, Faculty of Medicine, Khon Kaen University, 40002, Thailand
  • Pattapong Kessomboon Family Medicine Unit, Department of Community Medicine, Khon Kaen University, 40002, Thailand
  • Malinee Pisutthigoson Social Medicine Department, Khon kaen Hospital, Muang District, Khon kaen Province, 40000, Thailand
  • Wongjan Poolpoem English Program, Faculty of Education, Buriram Rajabhat University, Muang District, Buriram, 31000, Thailand
  • Thanamet Thaenkham Department of Community, Family and Occupational Medicine, Faculty of Medicine, Khon Kaen University, 40002, Thailand
  • Khachornsak Seevathee Donchan hospital, Kalasin Provincial Public Health Office, Ministry of Public Health,1000, Thailand

DOI:

https://doi.org/10.59796/jcst.V14N1.2024.4

Keywords:

Decision-making experience, medicinal cannabis, patients with knee osteoarthritis, care providers

Abstract

This study investigated the experience of making a decision to use medicinal cannabis among patients with knee osteoarthritis and their care providers. This qualitative research used a phenomenological approach to collect information by purposive sampling. Informants included 7 patients with knee osteoarthritis and 18 care providers in Khon Kaen municipality. Data were collected from June until December 2021using in-depth interviews, field records and participatory observation. After 6 months of data collection, the modified Colaizzi’s seven-step method was used for data analysis. The results show that the content from all informants can be categorized into 7 distinct themes about their decision-making on using medicinal cannabis (MC): 1) The needs for MC: Recognizing the painful nature of osteoarthritic pain and the limited treatment options available 2) Beliefs and attitudes towards MC with two sub-themes identified as 2.1) Belief in the MC’s efficacy that denotes informants’ positive perception and 2.2) Attitudes towards MC that show doubt, hesitation, or lack of confidence in MC’s effectiveness 3) Evidence on efficacy and safety of MC products: Considering cannabis as a viable treatment option 4) Trustworthiness of information and communication about MC. 5) Influence of other people: Three key influencers in the decision-making process including 5.1) Patients themselves 5.2) Friends and peers 5.3) Doctors and healthcare professionals 6) Legitimacy status of MC and 7) Product designs regarding forms of therapeutic use. The findings yielded 7 distinct themes concerning the decision to use medicinal cannabis (MC). The most important component is the need for pain relief among knee osteoarthritis patients. They clearly need MC for relieving their symptoms. Evidence on efficacy and legalization status of MC are also the main factors, while other 4 components are less important or not the vital factors for making decision on MC’s utilization. Policies on MC need to address these factors.

References

Altman, R., Asch, E., Bloch, D., Bole, G., Borenstein, D., Brandt, K., ... & Wolfe, F. (1986). Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis and Rheumatism, 29(8), 1039–1049. https://doi.org/10.1002/art.1780290816

Bindu, S., Mazumder, S., & Bandyopadhyay, U. (2020). Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective. Biochemical Pharmacology, 180, Article 114147. https://doi.org/10.1016/j.bcp.2020.114147

Boehnke, K. F., Gagnier, J. J., Matallana, L., & Williams, D. A. (2022). Cannabidiol product dosing and decision-making in a national survey of individuals with fibromyalgia. The Journal of Pain, 23(1), 45–54. https://doi.org/10.1016/j.jpain.2021.06.007

Boehnke, K. F., Scott, J. R., Litinas, E., Sisley, S., Clauw, D. J., Goesling, J., & Williams, D. A. (2019). Cannabis Use Preferences and Decision-making Among a Cross-sectional Cohort of Medical Cannabis Patients with Chronic Pain. The Journal of Pain, 20(11), 1362–1372. https://doi.org/10.1016/j.jpain.2019.05.009

Colaizzi, P. F. (1978). Psychological research as the phenomenologist views it. In R. S. Valle & M. King (Eds.) Existential-phenomenological alternatives for psychology (pp. 6). US, New York: Oxford University Press.

Cui, A., Li, H., Wang, D., Zhong, J., Chen, Y., & Lu, H. (2020). Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinical Medicine, 29–30, Article 100587. https://doi.org/10.1016/j.eclinm.2020.100587

Cyr, C., Davis, M. P., Schecter, D., & Daeninck, P. (2022). Cannabis and cannabinoid-based medicines in cancer care: A comprehensive guide to medical management. Switzerland, Cham: Springer.

Gamble, L. J., Boesch, J. M., Frye, C. W., Schwark, W. S., Mann, S., Wolfe, L., ... & Wakshlag, J. J. (2018). Pharmacokinetics, safety, and clinical efficacy of cannabidiol treatment in osteoarthritic dogs. Frontiers in Veterinary Science, 5, Article 165. https://doi.org/10.3389/fvets.2018.00165

Heng, M., McTague, M. F., Lucas, R. C., Harris, M. B., Vrahas, M. S., & Weaver, M. J. (2018). Patient perceptions of the use of medical marijuana in the treatment of pain after musculoskeletal trauma: A survey of patients at 2 trauma centers in Massachusetts. Journal of Orthopaedic Trauma, 32(1), e25–e30. https://doi.org/10.1097/BOT.0000000000001002

Kirnan, J. P., Farley, J. A., & Geisinger, K. F. (1989). The relationship between recruiting source, applicant quality, and hire performance: An analysis by sex, ethnicity, and age. Personnel Psychology, 42(2), 293–308. https://doi.org/10.1111/j.1744-6570.1989.tb00659.x

Kotler, P. (2000). Marketing management: Millennium Edition. (10th ed). Upper Saddle River, NJ: Prentice-Hall.

Litwic, A., Edwards, M. H., Dennison, E. M., & Cooper, C. (2013). Epidemiology and burden of osteoarthritis. British Medical Bulletin, 105(1), 185–199. https://doi.org/10.1093/bmb/lds038

Losina, E., Paltiel, A. D., Weinstein, A. M., Yelin, E., Hunter, D. J., Chen, S. P., ... & Katz, J. N. (2015). Lifetime medical costs of knee osteoarthritis management in the United States: Impact of extending indications for total knee arthroplasty. Arthritis Care & Research, 67(2), 203–215. https://doi.org/10.1002/acr.22412

Martell, K., Fairchild, A., LeGerrier, B., Sinha, R., Baker, S., Liu, H., ... & Kerba, M. (2018). Rates of cannabis use in patients with cancer. Current Oncology, 25(3), 219–225. https://doi.org/10.3747/co.25.3983

Mora, J. C., Przkora, R., & Cruz-Almeida, Y. (2018). Knee osteoarthritis: Pathophysiology and current treatment modalities. Journal of Pain Research, 11, 2189–2196. https://doi.org/10.2147/JPR.S154002

Mücke, M., Phillips, T., Radbruch, L., Petzke, F., & Häuser, W. (2018). Cannabis-based medicines for chronic neuropathic pain in adults. The Cochrane Database of Systematic Reviews, (3), Article CD012182. https://doi.org/10.1002/14651858.CD012182.pub2

Neogi, T. (2013). The epidemiology and impact of pain in osteoarthritis. Osteoarthritis and Cartilage, 21(9), 1145–1153. https://doi.org/10.1016/j.joca.2013.03.018

Newhart, M., & Dolphin, W. (2019). The medicalization of marijuana: Legitimacy, stigma, and the patient experience. US, New York: Routledge.

Peungsuwan, P., Chatchawan, U., Puntumetakul, R., & Yamauchi, J. (2019). The prevalence and work-related physical factors associated with knee pain in older Thai farmers. Journal of Physical Therapy Science, 31(6), 466–469. https://doi.org/10.1589/jpts.6.466

Philpot, L. M., Ebbert, J. O., & Hurt, R. T. (2019). A survey of the attitudes, beliefs and knowledge about medical cannabis among primary care providers. BMC Family Practice, 20(1), Article 17. https://doi.org/10.1186/s12875-019-0906-y

Piper, B. J., Beals, M. L., Abess, A. T., Nichols, S. D., Martin, M. W., Cobb, C. M., & DeKeuster, R. M. (2017). Chronic pain patients’ perspectives of medical cannabis. Pain, 158(7), 1373–1379. https://doi.org/10.1097/j.pain.0000000000000899

Rice, J., & Cameron, M. (2018). Cannabinoids for treatment of MS symptoms: State of the evidence. Current Neurology and Neuroscience Reports, 18(8), Article 50. https://doi.org/10.1007/s11910-018-0859-x

Rochford, C., Edgeworth, D., Hashim, M., & Harmon, D. (2019). Attitudes of Irish patients with chronic pain towards medicinal cannabis. Irish Journal of Medical Science, 188(1), 267–272. https://doi.org/10.1007/s11845-018-1761-x

Ruiz, D., Koenig, L., Dall, T. M., Gallo, P., Narzikul, A., Parvizi, J., & Tongue, J. (2013). The direct and indirect costs to society of treatment for end-stage knee osteoarthritis. The Journal of Bone and Joint Surgery. American Volume, 95(16), 1473–1480. https://doi.org/10.2106/JBJS.L.01488

Ryan, J. E., McCabe, S. E., & Boyd, C. J. (2021). Medicinal cannabis: Policy, patients, and providers. Policy, Politics & Nursing Practice, 22(2), 126–133. https://doi.org/10.1177/1527154421989609

Sexton, M., Cuttler, C., Finnell, J. S., & Mischley, L. K. (2016). A cross-sectional survey of medical cannabis users: Patterns of use and perceived efficacy. Cannabis and Cannabinoid Research, 1(1), 131–138. https://doi.org/10.1089/can.2016.0007

Singh, V., Zarrabi, A. J., Curseen, K. A., Sniecinski, R., Welsh, J. W., McKenzie-Brown, A. M., … Gillespie, T. W. (2019). Concerns of patients with cancer on accessing cannabis products in a state with restrictive medical marijuana laws: A survey study. Journal of Oncology Practice, 15(10), 531–538. https://doi.org/10.1200/JOP.19.00184

Stienrut, P., Pongpirul, K., Chanhom, P. J., Laopiyasakul, K., Nootim, P., Soisamrong, M., Assawamakin, A. (2020). Thai cannabis practice patterns and quality of life study (Thai Cannabis PQ): A preliminary analysis (abstract). Retrieved October 1, 2022, from https://kku.world/7ann2

Vučković, S., Srebro, D., Vujović, K. S., Vučetić, Č., & Prostran, M. (2018). Cannabinoids and pain: New insights from old molecules. Frontiers in Pharmacology, 9, Article 1259. https://doi.org/10.3389/fphar.2018.01259

Wilsey, B. L., Deutsch, R., Samara, E., Marcotte, T. D., Barnes, A. J., Huestis, M. A., & Le, D. (2016). A preliminary evaluation of the relationship of cannabinoid blood concentrations with the analgesic response to vaporized cannabis. Journal of Pain Research, 9, 587–598. https://doi.org/10.2147/JPR.S113138

Yangsud, J., Ahkkarachinoreh, P., Santasanasuwan, S., Suksaeree, J., Songsak, T., Maha, A., ... & Monton, C. (2021). Effect of vegetable oil types on the stability of cannabinoids in cannabis sublingual drops. Journal of Current Science and Technology, 11, 15-23. https://doi.org/10.14456/JCST.2021.4

Zeng, L., Lytvyn, L., Wang, X., Kithulegoda, N., Agterberg, S., Shergill, Y., ... & Busse, J. W. (2021). Values and preferences towards medical cannabis among people living with chronic pain: A mixed-methods systematic review. BMJ Open, 11(9), Article e050831. https://doi.org/10.1136/bmjopen-2021-050831

Zolotov, Y., Vulfsons, S., Zarhin, D., & Sznitman, S. (2018). Medical cannabis: An oxymoron? Physicians’ perceptions of medical cannabis. The International Journal on Drug Policy, 57, 4–10. https://doi.org/10.1016/j.drugpo.2018.03.025

Downloads

Published

2023-12-06

How to Cite

Sena, W., Kessomboon, P., Pisutthigoson, M., Poolpoem, W., Thaenkham, T., & Seevathee, K. (2023). Decision-Making Experiences to use Medicinal Cannabis: Perspectives from Patients with Knee Osteoarthritis and Their Care Providers. Journal of Current Science and Technology, 14(1), Article 4. https://doi.org/10.59796/jcst.V14N1.2024.4

Issue

Section

Research Article