ABSTRACT
OBJECTIVES: The COVID-19 pandemic has led to the prioritisation of teleconsultation instead of face-to-face encounters. However, teleconsultation revealed some shortcomings and undesirable effects that may counterbalance benefits. This study aims to explore the perspective of patients with chronic diseases on teleconsultation in primary care. This article also proposes recommendations to provide patient-oriented and appropriate teleconsultations. DESIGN: We conducted a qualitative descriptive study that explored the patients' perception regarding teleconsultation services and the following themes: access, perceived benefits and disadvantages, interprofessional collaboration, patient-centred approach, specific competencies of professionals, and patient's global needs and preferences. SETTING: Six primary care clinics in three regions of Quebec. PARTICIPANTS: 39 patients were interviewed by telephone through semistructured qualitative interviews. RESULTS: Patients want to maintain teleconsultation for the postpandemic period as long as their recommendations are followed: be able to choose to come to the clinic if they wish to, feel that their individual and environmental characteristics are considered, feel involved in the choice of the modality of each consultation, feel that interprofessional collaboration and patient-centred approach are promoted, and to maintain the professionalism, which must not be lessened despite the remote context. CONCLUSION: Patients mainly expressed high satisfaction with teleconsultation. However, several issues must be addressed. Patients do and should contribute to the implementation of teleconsultation in primary care. They wish to be frequently consulted about their preferred consultation modality, which may change over time. The patient perspective must, therefore, be part of the balanced implementation of optimal teleconsultation that is currently taking place.
Subject(s)
COVID-19 , Remote Consultation , Humans , COVID-19/epidemiology , Pandemics , Chronic Disease , Primary Health Care , PerceptionABSTRACT
Background: Medical cannabis has been legal in Canada since 2001, and recreational cannabis was legalized in October 2018, which has led to a widespread increase in the accessibility of cannabis products. Aims: This study aimed to estimate the prevalence of cannabis use among adults living with chronic pain (CP) and investigate the relationship between age and cannabis use for CP management. Methods: A cross-sectional analysis of the COPE Cohort data set, a large Quebec sample of 1935 adults living with CP, was conducted. Participants completed a web-based questionnaire in 2019 that contained three yes/no questions about past-year use of cannabis (i.e., for pain management, management of other health-related conditions, recreational purposes). Results: Among the 1344 participants who completed the cannabis use section of the questionnaire, the overall prevalence of cannabis use for pain management was 30.1% (95% confidence interval 27.7-32.7). Differences were found between age groups, with the highest prevalence among participants aged ≤26 years (36.5%) and lowest for those aged ≥74 years (8.8%). A multivariable logistic model revealed that age, region of residence, generalized pain, use of medications or nonpharmacological approaches for pain management, alcohol/drug consumption, and smoking were associated with the likelihood of using cannabis for pain management. Conclusions: Cannabis is a common treatment for the management of CP, especially in younger generations. The high prevalence of use emphasizes the importance of better knowledge translation for people living with CP, rapidly generating evidence regarding the safety and efficacy of cannabis, and clinicians' involvement in supporting people who use cannabis for pain management.
Contexte: Le cannabis médical est légal au Canada depuis 2001 et le cannabis récréatif a été légalisé en octobre 2018, ce qui a conduit à une augmentation généralisée de l'accessibilité des produits du cannabis. Objectifs: Cette étude visait à estimer la prévalence de la consommation de cannabis chez les adultes vivant avec la douleur chronique et à étudier l'association entre l'âge et la consommation de cannabis pour la prise en charge de la douleur chronique. Méthodes: Une analyse transversale de l'ensemble de données de la cohorte COPE, un grand échantillon québécois de 1 935 adultes vivant avec la douleur chronique, a été menée. En 2019, les participants ont rempli un questionnaire en ligne qui contenait trois questions oui/non sur la consommation de cannabis au cours de l'année écoulée (c.-à-d., pour la prise en charge de la douleur, la prise en charge d'autres affections liées à la santé, à des fins récréatives). Résultats: Parmi les 1 344 participants qui ont rempli la section du questionnaire portant sur la consommation de cannabis, la prévalence globale de la consommation de cannabis pour la prise en charge de la douleur était de 30,1 % (intervalle de confiance à 95 %, 27,7-32,7). Des différences ont été constatées entre les groupes d'âge, avec la prévalence la plus élevée chez les participants âgés de ≤ 26 ans (36,5 %) et la plus basse chez les participants âgés de ≥ 74 ans (8,8 %). Un modéle logistique multivariable a révélé que l'âge, la région de résidence, la douleur généralisée, l'utilisation de médicaments ou approches non pharmacologiques pour la prise en charge de la douleur, la consommation d'alcool/de drogue et le tabagisme étaient associés à la probabilité d'utiliser le cannabis pour la prise en charge de la douleur. Conclusions: Le cannabis est un traitement courant pour la prise en charge de la douleur chronique, en particulier chez les jeunes générations. La prévalence élevée de l'utilisation souligne l'importance d'un meilleur transfert des connaissances pour les personnes vivant avec la douleur chronique, en générant rapidement des donnant probantes concernant l'innocuité et l'efficacité du cannabis, ainsi que l'implication des cliniciens dans le soutien aux personnes qui consomment du cannabis pour la prise en charge de la douleur.