Abstract
Objectives: This project aimed to: 1) gather information on patterns of cannabis
use and their impacts on the health of chronic disease patients, and develop a
questionnaire; 2) describe the distribution of cannabis use quantitatively, per
sociodemographics, clinical information, and understandings regarding cannabis, and
examine the associations between cannabis use and medication adherence in non -
communicable disease (NCD) patients.
Methods: We employed sequential-exploratory mixed methods, including indepth interviews and an exposure-based cross-sectional survey. Four NCD clinics were
purposively selected from four levels of Thai healthcare centers: a community hospital,
a general hospital, a referral hospital, and a medical school hospital. We coordinated
with clinic staff to recruit study participants. When a cannabis user was identified during
routine care, investigators matched them with a non-cannabis-user patient with the same
medical conditions and being treated by the same physician, in a 1:1 ratio. We analyzed
the association between cannabis use and medication adherence using conditional
logistic regression.
Results: Two hundred and eighty patients participated in the survey, with 140
patients each reporting using and not using cannabis in the past three months. Most
participants were Buddhists, married, had primary school education, and a family
monthly income of less than 30,000 Thai Baht. Most cannabis users were male (58%).
Among the participants, 90.7% had hypertension and 62.1% had diabetes.
Cerebrovascular diseases and cancer were common comorbidities among cannabis users.
On average, cannabis users had used cannabis for 2.1 years, with 62.1% starting since
June 2022. Usage for medical purposes, recreational purposes, and both purposes were
40.0%, 16.4%, and 43.6%, respectively. The most common preparation was cannabis tea
(81.7%). Only 1.4% of participants received cannabis products from government health
centers. Cannabis users had a higher rate of loss to follow-up than non-users and were
more likely to understand cannabis's symptom-relieving effects correctly. However, these
users had limited understanding of scientifically proven therapeutic effects and cannabis
regulations in Thailand. Both cannabis users and non-users generally agreed that
cannabis use should be under a physician’s supervision. Cannabis use was significantl y
associated with low medication adherence in NCD patients (adjusted odds ratio 7.42,
95% confidence interval 1.21 – 45.48).
Summary: NCD patients commonly gained access to cannabis products after
June 2022, primarily through self-research, and were able to access various cannabis
products. Cannabis use was associated with low medication adherence. However, this
investigation was conducted only in Songkhla province, so caution should be taken when
generalizing certain parts of the study results to different settings.
