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