How Patients and Doctors Discuss Cannabis Through Hospital Messaging Systems

Analysis of nearly 383,000 patient portal messages found cannabis discussions shifted dramatically after medical legalization: from drug screening concerns to patients actively seeking help accessing medical marijuana.

Shetty, Vishal A et al.·Journal of medical Internet research·2024·Moderate EvidenceCross-Sectional
RTHC-05707Cross SectionalModerate Evidence2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=15,340

What This Study Found

Before medical cannabis legalization in Pennsylvania (2012-2016), cannabis-related messages were primarily about drug screening results (39% of patient messages, 77% of provider messages). After legalization (2017-2022), patient messages shifted to seeking medical cannabis access (35%) and reporting current use (25%). Provider responses were split between assisting with access (28%) and stating inability to prescribe or recommend (26%).

Key Numbers

1,782 patient messages from 1,098 patients (7.2% of total) and 800 provider messages from 430 providers (7%) discussed cannabis. Top reasons for patient use: pain (50.5%), anxiety (13.7%), sleep (11.1%). 56 different purposes coded in patient messages.

How They Did This

Content analysis of 382,982 secure messages from 15,340 patients and 6,101 providers at a Pennsylvania health system (2012-2022). Natural language processing identified cannabis-related messages, followed by qualitative coding of a random sample.

Why This Research Matters

Patient portal messages reveal how people actually communicate with their doctors about cannabis, bypassing the social desirability bias of face-to-face visits. The shift from screening-focused to access-focused discussions shows how legalization changes the patient-provider dynamic.

The Bigger Picture

The finding that one-quarter of provider responses after legalization stated inability to prescribe or recommend cannabis echoes the knowledge gap theme seen in other studies. Patients are ready to discuss cannabis; the healthcare system is not always ready to respond.

What This Study Doesn't Tell Us

Single health system in Pennsylvania limits generalizability. Only explicit cannabis mentions were captured; coded language may have been missed. The qualitative sample may not represent all cannabis-related messages.

Questions This Raises

  • ?Do patients who discuss cannabis via portal messages have different outcomes than those who do not?
  • ?Could AI-assisted message routing connect cannabis-inquiring patients with knowledgeable providers?

Trust & Context

Key Stat:
7.2% of patients discussed cannabis through their patient portal
Evidence Grade:
Large dataset with both quantitative and qualitative analysis, though limited to one health system.
Study Age:
2024 study using 2012-2022 data
Original Title:
Discussions of Cannabis Over Patient Portal Secure Messaging: Content Analysis.
Published In:
Journal of medical Internet research, 26, e63311 (2024)
Database ID:
RTHC-05707

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Do patients discuss cannabis with their doctors through online portals?

Yes. About 7% of patients in this study discussed cannabis through secure messaging. After medical cannabis legalization, the most common reason was seeking help accessing medical marijuana.

How did legalization change cannabis conversations between patients and doctors?

Before legalization, most cannabis messages were about drug test results. After legalization, patients shifted to requesting help with medical cannabis access, while about a quarter of provider responses said they could not prescribe or recommend it.

Read More on RethinkTHC

Cite This Study

RTHC-05707·https://rethinkthc.com/research/RTHC-05707

APA

Shetty, Vishal A; Gregor, Christina M; Tusing, Lorraine D; Pradhan, Apoorva M; Romagnoli, Katrina M; Piper, Brian J; Wright, Eric A. (2024). Discussions of Cannabis Over Patient Portal Secure Messaging: Content Analysis.. Journal of medical Internet research, 26, e63311. https://doi.org/10.2196/63311

MLA

Shetty, Vishal A, et al. "Discussions of Cannabis Over Patient Portal Secure Messaging: Content Analysis.." Journal of medical Internet research, 2024. https://doi.org/10.2196/63311

RethinkTHC

RethinkTHC Research Database. "Discussions of Cannabis Over Patient Portal Secure Messaging..." RTHC-05707. Retrieved from https://rethinkthc.com/research/shetty-2024-discussions-of-cannabis-over

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.