Patients' Perspectives and Experiences of Cannabinoids to Manage Symptoms of Chronic Kidney Disease: An In-Depth Interview Study

Abstract

Introduction

People with kidney failure experience severe, often intractable symptoms, which affect quality of life. These symptoms are often unacknowledged and difficult to treat due to few treatment options being available. The use of cannabinoids to treat symptoms of long-term medical conditions is increasing worldwide. However, there is a paucity of data on the experiences of people using cannabis to treat the specific symptoms of kidney disease.

Methods

We conducted a qualitative semistructured interview study involving patients who had used either prescribed or nonprescribed cannabis to manage symptoms of kidney failure. Data were coded inductively to identify themes and a conceptual framework.

Results

Thirteen participants had used nonprescribed cannabis and four prescribed cannabis. Most participants had experience of treatment with hemodialysis. We identified four themes and subthemes: Managing overwhelming symptom burden (using cannabinoids to relieve symptoms, alleviating the mental load, restricted by a lack of options, feeling abandoned managing symptom burden); Barriers to accessing medical cannabis (constrained by finances and avoiding stigma and judgment); Weighing up risks of nonprescribed cannabis (wanting to avoid illegal behavior, avoiding potential harm, concerns of safety with treatment, worried about the safety of nonregulated products, seeking only medicinal benefits); Lack of clinician support (poor provision of information, lack of knowledge of prescribed options, valuing honesty).

Conclusion

People with kidney failure describe frustration at the limited options for symptom management and appreciate the benefits of cannabis. Access to prescribed cannabis is restricted by legal issues and lack of clinician familiarity and confidence, which creates uncertainties and safety issues for patients when managing their symptoms.