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Prevalence of Medical Cannabis Use and Associated Health Conditions Documented in Electronic Health Records Among Primary Care Patients in Washington State

IMPORTANCE: Many people use cannabis for medical reasons despite limited evidence of therapeutic benefit and potential risks. Little is known about medical practitioners’ documentation of medical cannabis use or clinical characteristics of patients with documented medical cannabis use. OBJECTIVES: T...

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Autores principales: Matson, Theresa E., Carrell, David S., Bobb, Jennifer F., Cronkite, David J., Oliver, Malia M., Luce, Casey, Ghitza, Udi E., Hsu, Clarissa W., Campbell, Cynthia I., Browne, Kendall C., Binswanger, Ingrid A., Saxon, Andrew J., Bradley, Katharine A., Lapham, Gwen T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103224/
https://www.ncbi.nlm.nih.gov/pubmed/33956129
http://dx.doi.org/10.1001/jamanetworkopen.2021.9375
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author Matson, Theresa E.
Carrell, David S.
Bobb, Jennifer F.
Cronkite, David J.
Oliver, Malia M.
Luce, Casey
Ghitza, Udi E.
Hsu, Clarissa W.
Campbell, Cynthia I.
Browne, Kendall C.
Binswanger, Ingrid A.
Saxon, Andrew J.
Bradley, Katharine A.
Lapham, Gwen T.
author_facet Matson, Theresa E.
Carrell, David S.
Bobb, Jennifer F.
Cronkite, David J.
Oliver, Malia M.
Luce, Casey
Ghitza, Udi E.
Hsu, Clarissa W.
Campbell, Cynthia I.
Browne, Kendall C.
Binswanger, Ingrid A.
Saxon, Andrew J.
Bradley, Katharine A.
Lapham, Gwen T.
author_sort Matson, Theresa E.
collection PubMed
description IMPORTANCE: Many people use cannabis for medical reasons despite limited evidence of therapeutic benefit and potential risks. Little is known about medical practitioners’ documentation of medical cannabis use or clinical characteristics of patients with documented medical cannabis use. OBJECTIVES: To estimate the prevalence of past-year medical cannabis use documented in electronic health records (EHRs) and to describe patients with EHR-documented medical cannabis use, EHR-documented cannabis use without evidence of medical use (other cannabis use), and no EHR-documented cannabis use. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study assessed adult primary care patients who completed a cannabis screen during a visit between November 1, 2017, and October 31, 2018, at a large health system that conducts routine cannabis screening in a US state with legal medical and recreational cannabis use. EXPOSURES: Three mutually exclusive categories of EHR-documented cannabis use (medical, other, and no use) based on practitioner documentation of medical cannabis use in the EHR and patient report of past-year cannabis use at screening. MAIN OUTCOMES AND MEASURES: Health conditions for which cannabis use has potential benefits or risks were defined based on National Academies of Sciences, Engineering, and Medicine’s review. The adjusted prevalence of conditions diagnosed in the prior year were estimated across 3 categories of EHR-documented cannabis use with logistic regression. RESULTS: A total of 185 565 patients (mean [SD] age, 52.0 [18.1] years; 59% female, 73% White, 94% non-Hispanic, and 61% commercially insured) were screened for cannabis use in a primary care visit during the study period. Among these patients, 3551 (2%) had EHR-documented medical cannabis use, 36 599 (20%) had EHR-documented other cannabis use, and 145 415 (78%) had no documented cannabis use. Patients with medical cannabis use had a higher prevalence of health conditions for which cannabis has potential benefits (49.8%; 95% CI, 48.3%-51.3%) compared with patients with other cannabis use (39.9%; 95% CI, 39.4%-40.3%) or no cannabis use (40.0%; 95% CI, 39.8%-40.2%). In addition, patients with medical cannabis use had a higher prevalence of health conditions for which cannabis has potential risks (60.7%; 95% CI, 59.0%-62.3%) compared with patients with other cannabis use (50.5%; 95% CI, 50.0%-51.0%) or no cannabis use (42.7%; 95% CI, 42.4%-42.9%). CONCLUSIONS AND RELEVANCE: In this cross-sectional study, primary care patients with documented medical cannabis use had a high prevalence of health conditions for which cannabis use has potential benefits, yet a higher prevalence of conditions with potential risks from cannabis use. These findings suggest that practitioners should be prepared to discuss potential risks and benefits of cannabis use with patients.
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spelling pubmed-81032242021-05-24 Prevalence of Medical Cannabis Use and Associated Health Conditions Documented in Electronic Health Records Among Primary Care Patients in Washington State Matson, Theresa E. Carrell, David S. Bobb, Jennifer F. Cronkite, David J. Oliver, Malia M. Luce, Casey Ghitza, Udi E. Hsu, Clarissa W. Campbell, Cynthia I. Browne, Kendall C. Binswanger, Ingrid A. Saxon, Andrew J. Bradley, Katharine A. Lapham, Gwen T. JAMA Netw Open Original Investigation IMPORTANCE: Many people use cannabis for medical reasons despite limited evidence of therapeutic benefit and potential risks. Little is known about medical practitioners’ documentation of medical cannabis use or clinical characteristics of patients with documented medical cannabis use. OBJECTIVES: To estimate the prevalence of past-year medical cannabis use documented in electronic health records (EHRs) and to describe patients with EHR-documented medical cannabis use, EHR-documented cannabis use without evidence of medical use (other cannabis use), and no EHR-documented cannabis use. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study assessed adult primary care patients who completed a cannabis screen during a visit between November 1, 2017, and October 31, 2018, at a large health system that conducts routine cannabis screening in a US state with legal medical and recreational cannabis use. EXPOSURES: Three mutually exclusive categories of EHR-documented cannabis use (medical, other, and no use) based on practitioner documentation of medical cannabis use in the EHR and patient report of past-year cannabis use at screening. MAIN OUTCOMES AND MEASURES: Health conditions for which cannabis use has potential benefits or risks were defined based on National Academies of Sciences, Engineering, and Medicine’s review. The adjusted prevalence of conditions diagnosed in the prior year were estimated across 3 categories of EHR-documented cannabis use with logistic regression. RESULTS: A total of 185 565 patients (mean [SD] age, 52.0 [18.1] years; 59% female, 73% White, 94% non-Hispanic, and 61% commercially insured) were screened for cannabis use in a primary care visit during the study period. Among these patients, 3551 (2%) had EHR-documented medical cannabis use, 36 599 (20%) had EHR-documented other cannabis use, and 145 415 (78%) had no documented cannabis use. Patients with medical cannabis use had a higher prevalence of health conditions for which cannabis has potential benefits (49.8%; 95% CI, 48.3%-51.3%) compared with patients with other cannabis use (39.9%; 95% CI, 39.4%-40.3%) or no cannabis use (40.0%; 95% CI, 39.8%-40.2%). In addition, patients with medical cannabis use had a higher prevalence of health conditions for which cannabis has potential risks (60.7%; 95% CI, 59.0%-62.3%) compared with patients with other cannabis use (50.5%; 95% CI, 50.0%-51.0%) or no cannabis use (42.7%; 95% CI, 42.4%-42.9%). CONCLUSIONS AND RELEVANCE: In this cross-sectional study, primary care patients with documented medical cannabis use had a high prevalence of health conditions for which cannabis use has potential benefits, yet a higher prevalence of conditions with potential risks from cannabis use. These findings suggest that practitioners should be prepared to discuss potential risks and benefits of cannabis use with patients. American Medical Association 2021-05-06 /pmc/articles/PMC8103224/ /pubmed/33956129 http://dx.doi.org/10.1001/jamanetworkopen.2021.9375 Text en Copyright 2021 Matson TE et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Matson, Theresa E.
Carrell, David S.
Bobb, Jennifer F.
Cronkite, David J.
Oliver, Malia M.
Luce, Casey
Ghitza, Udi E.
Hsu, Clarissa W.
Campbell, Cynthia I.
Browne, Kendall C.
Binswanger, Ingrid A.
Saxon, Andrew J.
Bradley, Katharine A.
Lapham, Gwen T.
Prevalence of Medical Cannabis Use and Associated Health Conditions Documented in Electronic Health Records Among Primary Care Patients in Washington State
title Prevalence of Medical Cannabis Use and Associated Health Conditions Documented in Electronic Health Records Among Primary Care Patients in Washington State
title_full Prevalence of Medical Cannabis Use and Associated Health Conditions Documented in Electronic Health Records Among Primary Care Patients in Washington State
title_fullStr Prevalence of Medical Cannabis Use and Associated Health Conditions Documented in Electronic Health Records Among Primary Care Patients in Washington State
title_full_unstemmed Prevalence of Medical Cannabis Use and Associated Health Conditions Documented in Electronic Health Records Among Primary Care Patients in Washington State
title_short Prevalence of Medical Cannabis Use and Associated Health Conditions Documented in Electronic Health Records Among Primary Care Patients in Washington State
title_sort prevalence of medical cannabis use and associated health conditions documented in electronic health records among primary care patients in washington state
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103224/
https://www.ncbi.nlm.nih.gov/pubmed/33956129
http://dx.doi.org/10.1001/jamanetworkopen.2021.9375
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