Table 3 Themes and subthemes matched with theory of planned behavior components
From: Utilization of medicinal hemp: a qualitative analysis of clinicians’ perspectives in Ghana
Theory component | Theme | Subtheme |
|---|---|---|
Attitudes | Clinical use/ indication | Knowledge on medicinal hemp Clinical efficacy of medicinal hemp supported by scientific evidence Therapeutic application of medicinal hemp |
“Its use is not so common in our practice so most of the things I am telling you is based on literature…in mainstream neurology according to literature Medicinal cannabis can be used for refractory seizures and pain management, it could be oncology, neuropathic pain, it could be sickle cell.” “They will say they have the oil and they will swear by it that when they take it, it really helps to control their pain.” “Personally, I have no reservations because there’s literature out there that supports the use, and from personal experience with my patients it seems to help so if it’s legal if it’s really made legal then we can go ahead and prescribe.” | ||
Subjective norm | Sociocultural Classification of Hemp | Stigma/Acceptance of Hemp post legalization Mental health concerns for medicinal hemp Clinical non-prescription use of hemp |
“…You see there’s a big debate that marijuana causes mental health” “Yes, I do see concerns for mental health. You know any form of addiction is a disease…so like I said earlier the rational use of a drug is important, how you will ensure that the end users are using it right…that is going to be a problem it’s going to be a challenge.” “In our local context the hesitation cuts across. Even the younger age group who have tried it before will not openly accept that they have been doing it or they have used it before. They will pretend to have an aversion to it because they don’t want to seem like a bad person. Because in the general public eye it is not acceptable.” “The general hesitancy to even try medicinal cannabis is due to lack of knowledge. And lack of education” | ||
Perceived Behavioral Control | Control and management Adverse effects | Knowledge and perception of legislative structures Regulation of medicinal hemp |
“Currently there is no clinical policy or guidelines. It is not available in our national guidelines, so this use is on an individual basis, and we have found experience with it… “So far in terms of substances that have a potential of abuse, most of the time an effective management is to limit the people that can prescribe it such that only people who clearly know how to use and prescribe it are allowed to prescribe it and also limit the number of places that it is available, make sure that the places are licensed; somewhere that they can’t go over the counter to buy from some random pharmacy and that the places know what they are selling, who they are selling to and for what indication.” “Like any other drug they need to make sure the indications are clear, which level prescriptions should come from are clear and of course liaise with pharmacies so that they can’t be leaked and purchased for other purposes because that’s the problem.” “If we regulate it we can get a better medicinal benefit out of it. To harness its full potential, we have to regulate it.” “… it is very easy to get opioids in this country. Some pharmacists will not sell, others will sell because they are looking for money and don’t care whether there’s the indication or not. Even though it’s not supposed to be sold over the counter people go over the counter and buy tramadol…so unless we put in place measures that will limit let’s say the production, distribution, storage and medical application it’s going to be like the challenge we have with opioids” | ||
Behavioral Intention | Policy Landscape | Legislation shift of Medicinal hemp Inclusion of medicinal hemp in medical practice |
“It’s possible have medical advancement in the future towards the use of cannabis because in various countries it’s being legalized medically and of course everything comes with local research so if trials are confirmed locally and its efficacy in our population is saturated then it’s easier so I think it would be driven by research.” “Why not, anything that will help our patients and ourselves…there are drugs in use that are worse off even in their therapeutic use than cannabis but is being used in conventional medicine practice. It’s about having the right indications and right policies.” “I am not averse to prescribing it if it’s legal and made clear, I will prescribe it but not right from the onset.” | ||