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.
Quick Facts
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)
- Authors:
- Shetty, Vishal A, Gregor, Christina M(2), Tusing, Lorraine D(2), Pradhan, Apoorva M, Romagnoli, Katrina M, Piper, Brian J, Wright, Eric A
- Database ID:
- RTHC-05707
Evidence Hierarchy
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.
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Cite This Study
https://rethinkthc.com/research/RTHC-05707APA
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.