IntroductionStrong patient interest in the use of medicinal cannabis to treat various clinical indications has sparked global legislative changes. Practitioners are vital in implementing regulatory changes and facilitating patient access to medicinal cannabis, however, little is currently known about the factors influencing practitioners' uptake. Recent rapid increases in practitioner applications to prescribe medicinal cannabis in Australia provides a unique backdrop to examine the current factors influencing prescribing behaviours. This qualitative study examined Australian practitioners' perspectives on prescribing medicinal cannabis to provide a comprehensive exploration of the potential factors influencing uptake in clinical practice.MethodsSeventeen semi‐structured interviews were conducted with Australian health‐care practitioners. Transcripts were analysed using the Framework approach to thematic analysis and cross‐mapped to appropriate domains of the Theoretical Domains Framework.ResultsWe identified four themes related to the barriers and facilitators to prescribing medicinal cannabis: (i) clinical capabilities needed to prescribe; (ii) prescribing an unapproved therapeutic good; (iii) negative attitudes towards prescribers in the medical community; and (iv) divergent beliefs about clinical utility.Discussion and ConclusionsPractitioners face multiple pervasive barriers to prescribing medicinal cannabis. Beliefs about clinical utility appear to be highly influential in shaping prescribing behaviours. Moreover, our findings suggest that a medicinal cannabis ‘specialisation’ has emerged within the Australian medical community. Findings demonstrate that a range of complex and multifaceted factors influence practitioners' medicinal cannabis prescribing behaviours. We highlight several considerations for policy and practice to support safe and appropriate patient access to medicinal cannabis in this emerging area of clinical practice.

中文翻译：

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“医学的狂野西部”：对影响澳大利亚医疗保健从业人员提供药用大麻的因素的定性调查

简介患者对使用药用大麻治疗各种临床适应症的强烈兴趣引发了全球立法变革。从业者对于实施监管变革和促进患者获得药用大麻至关重要，然而，目前对影响从业者使用的因素知之甚少。最近，澳大利亚执业医师申请药用大麻处方的迅速增加，为研究当前影响处方行为的因素提供了独特的背景。这项定性研究调查了澳大利亚从业者对药用大麻处方的看法，以全面探讨影响临床实践中使用大麻的潜在因素。方法对澳大利亚医疗保健从业者进行了 17 次半结构化访谈。使用主题分析框架方法对成绩单进行分析，并交叉映射到理论领域框架的适当领域。结果我们确定了与处方药用大麻的障碍和促进因素相关的四个主题：(i) 处方所需的临床能力； (ii) 开出未经批准的治疗药品； (iii) 医学界对处方者的消极态度； (iv) 对临床效用的不同看法。 讨论和结论 从业者在开药用大麻处方时面临着多种普遍的障碍。对临床效用的信念似乎对处方行为的形成具有很大影响。此外，我们的研究结果表明，澳大利亚医学界已经出现了药用大麻“专业化”。调查结果表明，一系列复杂和多方面的因素影响从业者的药用大麻处方行为。我们强调了政策和实践的几个考虑因素，以支持患者在这一新兴临床实践领域安全和适当地获得药用大麻。