Abstract：
OBJECTIVE: To evaluate the patient-reported expectations regarding cannabis for pain following musculoskeletal (MSK) trauma and patients\' perceptions and attitudes regarding its use.
METHODS:
METHODS: A cross-sectional retrospective survey-based study.
METHODS: Three orthopaedic clinics in Ontario (Level-1 trauma center, Level-2 trauma center, rehabilitation clinic).
UNASSIGNED: Adult patients presenting to the clinics from January 24, 2018, to March 7, 2018, with traumatic MSK injuries (fractures/dislocations and muscle/tendon/ligament injury) were administered an anonymous questionnaire on cannabis for MSK pain.
UNASSIGNED: Primary outcome measure was the patients\' perceived effect of cannabis on MSK pain, reported on a continuous pain scale (0%-100%, 0 being no pain, and 100 unbearable pain). Secondary outcomes included preferences, such as administration route, distribution method, timing, and barriers (lack of knowledge, concerns for side effects/addiction, moral/religious opposition, etc.) regarding cannabis use.
RESULTS: In total, 440 patients were included in this study, 217 (49.3%) of whom were female and 222 (50.5%) were male, with a mean age of 45.6 years (range 18-92 years, standard deviations 15.6). Patients estimated that cannabis could treat 56.5% (95% CI 54.0%-59.0%) of their pain and replace 46.2% (95% CI 42.8%-49.6%) of their current analgesics. Nearly one-third (131/430, 30.5%) reported that they had used medical cannabis and more than one-quarter (123/430, 28.6%) used it in the previous year. Most felt that cannabis may be beneficial to treat pain (304/334, 91.0%) and reduce opioid use (293/331, 88.5%). Not considering using cannabis for their injury (132/350, 37.7%) was the most common reason for not discussing cannabis with physicians. Higher reported pain severity (β = 0.2/point, 95% CI 0.1-0.3, P = 0.005) and previous medical cannabis use were associated with higher perceived pain reduction (β = 11.1, 95% CI 5.4-16.8, P < 0.001).
CONCLUSIONS: One in 3 orthopaedic trauma patients used medical cannabis. Patients considered cannabis could potentially be an effective option for managing traumatic MSK pain and believed that cannabis could reduce opioid usage following acute musculoskeletal trauma. These data will help inform clinicians discussing medical cannabis usage with orthopaedic trauma patients moving forward.
METHODS:
METHODS: A cross-sectional retrospective survey-based study.
METHODS: Three orthopaedic clinics in Ontario (Level-1 trauma center, Level-2 trauma center, rehabilitation clinic).
UNASSIGNED: Adult patients presenting to the clinics from January 24, 2018, to March 7, 2018, with traumatic MSK injuries (fractures/dislocations and muscle/tendon/ligament injury) were administered an anonymous questionnaire on cannabis for MSK pain.
UNASSIGNED: Primary outcome measure was the patients\' perceived effect of cannabis on MSK pain, reported on a continuous pain scale (0%-100%, 0 being no pain, and 100 unbearable pain). Secondary outcomes included preferences, such as administration route, distribution method, timing, and barriers (lack of knowledge, concerns for side effects/addiction, moral/religious opposition, etc.) regarding cannabis use.
RESULTS: In total, 440 patients were included in this study, 217 (49.3%) of whom were female and 222 (50.5%) were male, with a mean age of 45.6 years (range 18-92 years, standard deviations 15.6). Patients estimated that cannabis could treat 56.5% (95% CI 54.0%-59.0%) of their pain and replace 46.2% (95% CI 42.8%-49.6%) of their current analgesics. Nearly one-third (131/430, 30.5%) reported that they had used medical cannabis and more than one-quarter (123/430, 28.6%) used it in the previous year. Most felt that cannabis may be beneficial to treat pain (304/334, 91.0%) and reduce opioid use (293/331, 88.5%). Not considering using cannabis for their injury (132/350, 37.7%) was the most common reason for not discussing cannabis with physicians. Higher reported pain severity (β = 0.2/point, 95% CI 0.1-0.3, P = 0.005) and previous medical cannabis use were associated with higher perceived pain reduction (β = 11.1, 95% CI 5.4-16.8, P < 0.001).
CONCLUSIONS: One in 3 orthopaedic trauma patients used medical cannabis. Patients considered cannabis could potentially be an effective option for managing traumatic MSK pain and believed that cannabis could reduce opioid usage following acute musculoskeletal trauma. These data will help inform clinicians discussing medical cannabis usage with orthopaedic trauma patients moving forward.
摘要：
目的：评估患者报告的对肌肉骨骼（MSK）创伤后疼痛的大麻的期望以及患者对其使用的看法和态度。
方法：
方法：基于横断面回顾性调查的研究。
方法：安大略省的三个骨科诊所（一级创伤中心，二级创伤中心,康复诊所)。
■从2018年1月24日至2018年3月7日在诊所就诊的患有创伤性MSK损伤（骨折/脱位和肌肉/肌腱/韧带损伤）的成年患者接受了一份关于大麻MSK疼痛的匿名问卷。
■主要结局指标是患者认为大麻对MSK疼痛的影响，以连续疼痛量表(0%-100%，0没有痛苦，和100难以忍受的疼痛)。次要结果包括偏好，如给药途径，分配方法，定时,和障碍(缺乏知识，对副作用/成瘾的担忧，道德/宗教反对，等。)关于大麻的使用。
结果：总计，440名患者被纳入本研究，其中217人(49.3%)为女性,222人(50.5%)为男性,平均年龄45.6岁(范围18-92岁，标准偏差15.6)。患者估计，大麻可以治疗56.5%(95%CI54.0%-59.0%)的疼痛，并取代46.2%(95%CI42.8%-49.6%)的目前镇痛药。近三分之一(131/430，30.5%)报告说他们使用了医用大麻，超过四分之一(123/430，28.6%)在前一年使用了医用大麻。大多数人认为大麻可能有益于治疗疼痛（304/334，91.0％）和减少阿片类药物的使用（293/331，88.5％）。不考虑使用大麻伤害（132/350，37.7％）是不与医生讨论大麻的最常见原因。报告的疼痛严重程度更高（β=0.2/点，95％CI0.1-0.3，P=0.005）和以前的医疗大麻使用与更高的感知疼痛减轻相关（β=11.1，95％CI5.4-16.8，P<0.001）。
结论：三分之一的骨科创伤患者使用医用大麻。患者认为大麻可能是治疗创伤性MSK疼痛的有效选择，并认为大麻可以减少急性肌肉骨骼创伤后阿片类药物的使用。这些数据将有助于告知临床医生讨论骨科创伤患者的医疗大麻使用情况。
方法：
方法：基于横断面回顾性调查的研究。
方法：安大略省的三个骨科诊所（一级创伤中心，二级创伤中心,康复诊所)。
■从2018年1月24日至2018年3月7日在诊所就诊的患有创伤性MSK损伤（骨折/脱位和肌肉/肌腱/韧带损伤）的成年患者接受了一份关于大麻MSK疼痛的匿名问卷。
■主要结局指标是患者认为大麻对MSK疼痛的影响，以连续疼痛量表(0%-100%，0没有痛苦，和100难以忍受的疼痛)。次要结果包括偏好，如给药途径，分配方法，定时,和障碍(缺乏知识，对副作用/成瘾的担忧，道德/宗教反对，等。)关于大麻的使用。
结果：总计，440名患者被纳入本研究，其中217人(49.3%)为女性,222人(50.5%)为男性,平均年龄45.6岁(范围18-92岁，标准偏差15.6)。患者估计，大麻可以治疗56.5%(95%CI54.0%-59.0%)的疼痛，并取代46.2%(95%CI42.8%-49.6%)的目前镇痛药。近三分之一(131/430，30.5%)报告说他们使用了医用大麻，超过四分之一(123/430，28.6%)在前一年使用了医用大麻。大多数人认为大麻可能有益于治疗疼痛（304/334，91.0％）和减少阿片类药物的使用（293/331，88.5％）。不考虑使用大麻伤害（132/350，37.7％）是不与医生讨论大麻的最常见原因。报告的疼痛严重程度更高（β=0.2/点，95％CI0.1-0.3，P=0.005）和以前的医疗大麻使用与更高的感知疼痛减轻相关（β=11.1，95％CI5.4-16.8，P<0.001）。
结论：三分之一的骨科创伤患者使用医用大麻。患者认为大麻可能是治疗创伤性MSK疼痛的有效选择，并认为大麻可以减少急性肌肉骨骼创伤后阿片类药物的使用。这些数据将有助于告知临床医生讨论骨科创伤患者的医疗大麻使用情况。
