title: Rheumatologists lack confidence in their knowledge of cannabinoids pertaining to the management of rheumatic complaints.
abstract: BACKGROUND
  Arthritis pain is reported as one of the most common reasons for persons using medical herbal cannabis in North America. "Severe arthritis" is the condition justifying legal use of cannabis in over half of all authorizations in Canada, where cannabis remains a controlled substance. As champions for the care of persons with arthritis, rheumatologists must be knowledgeable of treatment modalities both traditional and non-traditional, used by their patients. As study of cannabinoid molecules in medicine is recent, we have examined the confidence in the knowledge of cannabinoids expressed by Canadian rheumatologists.
  
  
  METHODS
  The confidence of rheumatologists in their knowledge of cannabinoid molecules and mechanisms relevant to rheumatology, and their ability to advise patients about cannabinoid treatments was recorded by an online questionnaire circulated via email to the entire Canadian Rheumatology Association membership.
  
  
  RESULTS
  Over three quarters of the 128 respondents lacked confidence in their knowledge of cannabinoid molecules. While 45% of respondents believed there was no current role for cannabinoids in rheumatology patient care, only 25% supported any use of herbal cannabis. With 70% never having previously prescribed or recommended any cannabinoid treatment, uncertainty regarding good prescribing practices was prevalent. Concerns about risks of cannabis use were in line with the current literature.
  
  
  CONCLUSIONS
  Rheumatologists lacked confidence in their knowledge of cannabinoid molecules in general and in their competence to prescribe any cannabinoid for rheumatic complaints. In line with this uncertainty, there is reticence to prescribe cannabinoid preparations for rheumatology patients. Guidance is required to inform rheumatologists on the evidence regarding cannabinoids.
authors: Division of Rheumatology, Montreal General Hospital, McGill University Health Centre, 1650 Cedar ave, Montreal, Quebec H3G 1A4, Canada. mary-ann.fitzcharles@muhc.mcgill.ca.
authors: Mary-Ann
authors: MA
authors: Fitzcharles
authors: Peter A
authors: PA
authors: Ste-Marie
authors: Daniel J
authors: DJ
authors: Clauw
authors: Shahin
authors: S
authors: Jamal
authors: Jacob
authors: J
authors: Karsh
authors: Sharon
authors: S
authors: LeClercq
authors: Jason J
authors: JJ
authors: McDougall
authors: Yoram
authors: Y
authors: Shir
authors: Kam
authors: K
authors: Shojania
authors: Zach
authors: Z
authors: Walsh
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D018771:Arthralgia / Q000175:diagnosis / Q000188:drug therapy*; D001168:Arthritis / Q000175:diagnosis / Q000188:drug therapy*; D001291:Attitude of Health Personnel; D002170:Canada; D002186:Cannabinoids / Q000627:therapeutic use*; D002983:Clinical Competence; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D012219:Rheumatology; D011795:Surveys and Questionnaires; D035501:Uncertainty
chemical_list: D018501:Antirheumatic Agents; D002186:Cannabinoids