Predicting Physicians' Intentions to Recommend Medical Cannabis

Context. Although medical cannabis (MC) policies continue to evolve around the world, the integration of MC into clinical practice remains highly debated within the medical community. Objectives. Relying on the Theory of Planned Behavior (TPB), this study aim was to identify underlying factors that influence physicians' intentions to recommend MC to patients and to examine whether there are differences in the strength of these associations across three medical specialties (family medicine, oncology, and pain medicine). Methods. 247 physicians completed questionnaires including measures of TPB constructs (attitudes, subjective norms, and perceived behavioral control) and intentions to recommend MC to two clinical vignettes describing medical background of a cancer and a chronic pain patient. Regression models were used to measure the extent to which perceived knowledge and TPB constructs predict physicians' intentions to recommend MC. Results. Physicians' intentions to recommend MC to the cancer patient vignette was higher than their intentions to recommend to the chronic pain patient vignette. Intentions to recommend MC to the patient with cancer were associated with more favorable attitudes toward MC, whereas intentions to recommend MC to the patient with chronic pain were associated with more favorable attitudes, higher levels of perceived control, and lower levels of perceived knowledge. Conclusion. Clinical practices related to MC may be influenced by nonmedical factors, and this may be particularly prevailing in the field of chronic pain, suggesting that MC may be particularly contentious in this field. (C) 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.