The Information-Seeking Behavior and Unmet Knowledge Needs of Older Medicinal Cannabis Consumers in Canada: A Qualitative Descriptive Study

Drugs & Aging https://doi.org/10.1007/s40266-023-01030-8 ORIGINAL RESEARCH ARTICLE The Information‑Seeking Behavior and Unmet Knowledge Needs of Older Medicinal Cannabis Consumers in Canada: A Qualitative Descriptive Study Jeffrey I. Butler1 · Sherry Dahlke1 · Rashmi Devkota1 · Shovana Shrestha1 · Kathleen F. Hunter1 Madeline Toubiana2 · Maya R. Kalogirou3 · Joanna Law1 · Melissa Scheuerman1,4 · Accepted: 5 April 2023 © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2023 Abstract Introduction Older Canadians (age 60+) are increasingly using cannabis to treat their health problems, but little is known regarding how they learn about medicinal cannabis. This study explored the perspectives of older cannabis consumers, prospective consumers, healthcare professionals, and cannabis retailers on older adults’ information-seeking behavior and unmet knowledge needs. Methods A qualitative descriptive design was used. Semi-structured telephone interviews were conducted with a purposeful sample of 36 older cannabis consumers and prospective consumers, as well as 4 healthcare professionals and 5 cannabis retailers from across Canada, for a total sample of 45 participants. Data were thematically analyzed. Results Three main themes characterizing older cannabis consumers’ information-seeking were identified: (1) knowledge sources, (2) types of information sought, and (3) unmet knowledge needs. Participants accessed a variety of knowledge sources to inform themselves about medicinal cannabis. Cannabis retailers were identified as providing medical information to many older adults, despite regulations to the contrary. Cannabis-specialized healthcare professionals were also viewed as key knowledge sources, while primary care providers were perceived as both knowledge sources and gatekeepers limiting access to information. The types of information participants sought included the effects and potential benefits of medicinal cannabis, the side effects and risks involved, and guidance regarding suitable cannabis products. Participants’ most salient unmet knowledge needs focused on dosing and use of cannabis to treat specific health conditions. Discussion Findings suggest that barriers to learning about medical cannabis among older consumers identified in prior research remain pervasive and cut across jurisdictions. To address these barriers, there is a need for better knowledge products tailored to older cannabis consumers and their information needs, and further education for primary healthcare providers on medicinal cannabis and its therapeutic applications with older patients. 1 Background Older adults (aged 60+) are the demographic group with the largest increase in cannabis consumption in both Canada and the USA in recent years [1–4], and older adults are more likely than younger adults to consume cannabis for health reasons [5–7]. Prior research on cannabis, however, has predominantly focused on younger people [8], and some studies have grouped older adults with people over * Jeffrey I. Butler * Sherry Dahlke Extended author information available on the last page of the article the age of 50 [9, 10], even though responses to cannabis can vary greatly between 50-year-olds and those 60+ (e.g., likelihood of falls). It is only in recent years, as older adults’ consumption of cannabis has increased dramatically, that their experiences with medicinal cannabis have received greater attention in the scholarly literature [11–21]. To consume cannabis safely and effectively, older adults require information about the therapeutic use of cannabidiol (CBD) and tetrahydrocannabinol (THC) as well as cannabis products and modes of delivery (e.g., oil, edibles, vaporization, topical creams). Yet older adults may not know how best to access related information or be reluctant to discuss cannabis with their healthcare providers [11, 15] due to the stigma associated with it. This reluctance may prevent older adults from receiving accurate information, thereby increasing the Vol.:(0123456789) J. I. Butler et al. Key Points This exploratory study contributes to the growing literature on medicinal cannabis consumption among adults aged 60+ by elucidating their information-seeking behavior and unmet knowledge needs from the perspectives of both older consumers and information providers. There is a need for better knowledge of products tailored to older cannabis consumers to meet their information needs and combat stigma that may lead them to avoid discussing cannabis with healthcare professionals. Primary healthcare providers, particularly physicians, lack knowledge about medicinal cannabis and often “shut down” older persons’ questions about it. We recommend that healthcare providers complete existing educational modules focused on medical cannabis and older adults, and that education on medicinal cannabis be integrated into continuing education credit programs for healthcare providers to incentivize their learning. possibility of drug interactions with their other medications, as well as a heightened risk of harmful side effects or negative health consequences due to multiple comorbidities and age-related changes [8, 22]. Some recent prior research has examined information-seeking among older cannabis consumers [11, 15, 18]. However, very few studies have explored the topic in Canada. Baumbusch and Yip [20] reported on information seeking in this population, but as part of older Canadians’ experiences with cannabis more broadly, and only from the perspective of older consumers. Given that medical cannabis access and consumption in Canada has changed due to the legalization of recreational cannabis in 2018 [21] and continues to evolve, there is a need for further research into older Canadian consumers’ information-seeking behaviour and knowledge needs from the perspectives of both the older adults seeking information and those advising them. 1.1 Study Objectives To build knowledge in this area, this study aimed to understand older consumers’ experiences of accessing information about cannabis for medicinal reasons from the perspectives of both the older consumers receiving information and the advisors providing it. The research questions were: a. How do older adults go about accessing information about medicinal cannabis and what information sources do they consult? b. What type of information do they seek? c. What are their most pressing unmet knowledge needs? 1.2 Medicinal Cannabis Use among Older Consumers Cannabis has been used for millennia to treat conditions such as rheumatism, pain, sleep, inflammation, nausea, anxiety, sleep issues, and depression [7, 15, 19, 23–26]. Studies show that older consumers commonly seek out cannabis for health reasons such as managing pain [5, 15, 27–29], and that older adults’ prior history with cannabis impacts their current perceptions of it as a treatment option [13]. Research on cannabis efficacy and safety in older adult (...truncated)