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Discussions of Cannabis Over Patient Portal Secure Messaging: Content Analysis.
Vishal A Shetty1,2, Christina M Gregor1, Lorraine D Tusing1
1Center for Pharmacy Innovation and Outcomes, Geisinger, Danville, PA, United States.
Journal of Medical Internet Research
|December 12, 2024
Summary
Patients increasingly discuss cannabis use via secure messages after medical marijuana legalization, seeking assistance and reporting use. Providers offer access help or caution on risks, highlighting care process improvement needs.
Area of Science:
- Health Informatics
- Patient-Provider Communication
- Cannabis Research
Background:
- Patient portal secure messaging captures health behaviors beyond standard electronic health records (EHRs).
- Limited understanding exists regarding cannabis discussions within patient portal secure messaging platforms.
Purpose of the Study:
- Identify patient and provider secure messages discussing cannabis.
- Contextualize these discussions before and after medical cannabis legalization in Pennsylvania.
Main Methods:
- Analyzed 382,982 secure messages (Jan 2012-June 2022) from a Pennsylvania health system.
- Employed unsupervised natural language processing to build a cannabis discussion lexicon.
- Conducted qualitative content analysis on sampled messages to determine reasons for use and discussion purposes.
Main Results:
- 1782 patient and 800 provider messages explicitly discussed cannabis.
- Top patient reasons: pain (50.5%), anxiety (13.7%), sleep (11.1%).
- Post-legalization, patient messages focused on seeking medical use assistance (35.2%) and reporting use (25.3%); provider messages involved access assistance (27.5%) or inability to refer/prescribe (26.3%).
Conclusions:
- Patients actively discuss cannabis use and interest post-legalization.
- Provider responses varied, offering access assistance or risk warnings.
- Health systems can leverage secure message insights to enhance care processes for patients using cannabis.
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