Browsing by Author "Withanarachchie V"

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    Barriers and facilitators to prescribing medicinal cannabis in New Zealand.
    (CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners, 2023-03-02) Withanarachchie V; Rychert M; Wilkins C; Goodyear-Smith F
    Introduction: The New Zealand Medicinal Cannabis Scheme (NZMCS) was established in April 2020 with the aim of expanding access to quality controlled medicinal cannabis products and developing a domestic medicinal cannabis industry. Yet, two years later, many patients report challenges in utilising the NZMCS, including physicians’ reluctance to provide prescriptions for products. Aim: To explore the barriers and facilitators to prescribing medicinal cannabis in New Zealand. Methods: We conducted semi-structured interviews with 31 New Zealand physicians (general practitioners, specialists, and cannabis clinicians) who had discussed medicinal cannabis with patients in the last 6 months. Results: Physicians reported the principal barrier to prescribing medicinal cannabis was the limited clinical evidence to support cannabis therapy. Further barriers included: a perceived lack of knowledge of medicinal cannabis; concerns over professional reputation; social stigma; and the price of products. Conversely, the factors that facilitated cannabis prescribing included patients’ and physicians’ knowledge of medicinal cannabis; some physicians’ desire to avoid patients having to engage with private cannabis clinics; and the timing of prescription requests (ie considering medicinal cannabis after other treatments had been exhausted). Discussion: Further clinical research of medicinal cannabis medications, education and training, and information would support physicians to deliver more informed advice to patients and enhance professional confidence with cannabis therapies.
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    The role of cannabis clinics in the health system: a qualitative study of physicians' views in New Zealand
    (BioMed Central Ltd, 2023-01-04) Withanarachchie V; Rychert M; Wilkins C
    Background Privately-owned cannabis clinics have sprung up in many jurisdictions where medicinal cannabis has been legalised and provide an alternative pathway for patients who are unable or unwilling to access a prescription for cannabis-based medicinal products from their usual healthcare providers. Aims This study aimed to explore physicians’ views on cannabis clinics, including their perceptions of the role cannabis clinics play in the wider health system. Methods A qualitative study using in-depth, semi-structured interviews with thirty-one physicians affiliated with private and community clinics in New Zealand (including cannabis clinicians, GPs, and specialist doctors). The interviews were conducted from July to December 2021. Data were transcribed and analysed using inductive thematic analysis. Results Cannabis clinicians positioned themselves as (1) “service providers”, facilitating consumer access to cannabis prescriptions and products, and (2) “educators”, providing advice to patients and the wider physician community. While general practitioners and specialists recognised the benefits of specialised cannabis clinics (i.e., knowledge of products and a non-judgmental environment), they questioned the limited evidence of clinical efficacy for cannabis, potential financial conflicts of interests of cannabis clinicians that may blur their clinical judgement, and the risk of compartmentalising patients’ healthcare. Conclusions Our paper raises a number of challenges with attempting to integrate cannabis clinics into the wider health system.