Abstracts

Rationale: It is unclear what US health professionals know and think about cannabidiol (CBD) and other cannabis-based therapies for treatment-resistant epilepsy (TRE), epilepsy in general, and other health problems. Older, regional, and international survey data suggest mixed knowledge of and attitudes toward cannabis-based therapies among physicians and health care professional trainees, but contemporary information from diverse professional groups on the national scale is not available. Methods: Quota-based online survey of US neurologists (n=151), pharmacists (n=150), and nurses (n=150 [60 NPs]) tapped attitudes toward cannabis therapies and perceived and actual knowledge of endocannabinoid system, pharmacology, FDA approval, and other aspects of cannabis therapies. 2 scales and a knowledge test score were constructed. Provider’s state marijuana laws ranged from “no marijuana access laws” to “recreational adult/medical marijuana allowed.” Demographics, work setting, patient population, and organizational policy regarding cannabis therapies were also assessed. Associations between attitudes, perceived knowledge, knowledge test, and other variables (provider type, patient population, state laws, etc.) were examined using one-way ANOVA, Pearson correlations, and multiple regression. Results: 53% were female, 83% white; 40% worked in private practice, 24% in academic hospitals. 58% practiced in states with comprehensive medical marijuana law, 22% in states with CBD/low THC law, 16% in states with adult/medical use law, 3% in states with no marijuana access laws. Weak positive associations were observed among perceived knowledge, knowledge test, and attitudes (p<0.001; Table 1). Attitudes/knowledge did not vary by state law (p≥0.247). Neurologists had less positive attitudes than nurses (p=0.02), but knowledge was similar across provider groups (p≥0.114). Attitudes/knowledge were associated with more epilepsy/TRE in practice (p≤0.02). Neurologists: Perceived and actual knowledge were not related (p=0.087); academic position and more pediatric/TRE patients were associated with a higher test score (p≤0.005). Pharmacists: Academic position and being female were associated with higher perceived knowledge (p≤0.029). Nurses: More epilepsy/TRE and hospital work were associated with higher while age was associated with lower perceived knowledge (p≤0.029). NPs: More epilepsy in practice was associated with positive attitudes/higher perceived knowledge; serving pediatric patients was associated with a higher knowledge test score (p≤0.021); hospital work was positively and no-cannabis setting was negatively related to perceived knowledge (p≤0.043). Higher perceived knowledge and nurse or pharmacist type were the strongest predictors of positive attitudes (p≤0.006; Table 2). Conclusions: Serving epilepsy/pediatric populations is associated with more positive attitudes and higher knowledge regarding CBD/cannabis-based therapies among US neurologists, nurses, and pharmacists. State laws do not shape providers’ knowledge/attitudes, but, for some providers, organizational restrictions are associated with less knowledge. Attitudes about CBD are generally positive among providers. More representative data and professional cannabinoid education are needed. Funding: Greenwich Biosciences, Inc.