Howard Meng1, M Gabrielle Page2, Prabjit Ajrawat3, Amol Deshpande4, Bana Samman3, Mary Dominicis3, Karim S Ladha5,6, Joseph Fiorellino1,3,6,7, Alexander Huang1,3,7, Yuvaraj Kotteeswaran8, Alex McClaren-Blades1,3,7, Lakshmi P Kotra6,9,10, Hance Clarke11,12,13,14,15,16,17. 1. Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada. 2. Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Département d'anesthésiology et médecine de la douleur, Faculté de médecine, Université de Montréal, Montreal, QC, Canada. 3. Department of Anesthesia, Toronto General Hospital, Toronto, ON, Canada. 4. Toronto Rehabilitation Institute, Toronto, ON, Canada. 5. Department of Anesthesia, St. Michael's Hospital, Toronto, ON, M5B 1W8, Canada. 6. Centre For Cannabinoid Therapeutics, Toronto, ON, Canada. 7. Transitional Pain Service, Toronto General Hospital, Toronto, ON, Canada. 8. Department of Anesthesia, Northern Ontario School of Medicine, Thunder Bay, ON, Canada. 9. Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada. 10. Krembil Research Institute, University Health Network, Toronto, ON, Canada. 11. Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada. hance.clarke@uhn.ca. 12. Department of Anesthesia, Toronto General Hospital, Toronto, ON, Canada. hance.clarke@uhn.ca. 13. Centre For Cannabinoid Therapeutics, Toronto, ON, Canada. hance.clarke@uhn.ca. 14. Transitional Pain Service, Toronto General Hospital, Toronto, ON, Canada. hance.clarke@uhn.ca. 15. Krembil Research Institute, University Health Network, Toronto, ON, Canada. hance.clarke@uhn.ca. 16. Pain Research Unit, Department of Anesthesia and Pain Management, GoodHope Ehlers Danlos Clinic, Toronto General Hospital, Toronto, ON, M5G 2C4, Canada. hance.clarke@uhn.ca. 17. University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, ON, Canada. hance.clarke@uhn.ca.
Abstract
PURPOSE: We investigated patients with chronic pain seeking medical cannabis. We assessed their demographics, patterns of cannabis use, and the long-term effectiveness of cannabis on their pain and functional domains. METHODS: This observational study enrolled patients between 8 September 2015 and 31 July 2018 from community-based cannabis clinics in Ontario, Canada. In addition to collecting demographic information, the primary outcomes studied were pain intensity and pain-related interference scores assessed at baseline, three, six, and 12 months. Using validated questionnaires, we also assessed anxiety, depression, quality of life (QoL), general health symptoms, neuropathic pain, self-reported opioid consumption, and adverse events. RESULTS: Of the 1,000 patients consented, 757 (76%) participated at one or more of the study time points. At six and 12 months, 230 (30.4%) and 104 (13.7%) of participants were followed up, respectively. Most participants were female (62%), Caucasian (91%), and sought cannabis for pain relief (88%). Time was a significant factor associated with improvement in pain intensity (P < 0.001), pain-related interference scores (P < 0.001), QoL (P < 0.001), and general health symptoms (P < 0.001). Female sex was significantly associated with worse outcomes than male sex including pain intensity (P < 0.001) and pain-related interference (P < 0.001). The proportion of individuals who reported using opioids decreased by half, from 40.8% at baseline to 23.9% at 12 months. CONCLUSION: Despite significant challenges to collecting long-term observational data on patients who attempted a trial of cannabis products, approximately one-third of patients in the cohort remained on medical cannabis for six months. In this cohort, pain intensity and pain-related interference scores were reduced and QoL and general health symptoms scores were improved compared with baseline.
PURPOSE: We investigated patients with chronic pain seeking medical cannabis. We assessed their demographics, patterns of cannabis use, and the long-term effectiveness of cannabis on their pain and functional domains. METHODS: This observational study enrolled patients between 8 September 2015 and 31 July 2018 from community-based cannabis clinics in Ontario, Canada. In addition to collecting demographic information, the primary outcomes studied were pain intensity and pain-related interference scores assessed at baseline, three, six, and 12 months. Using validated questionnaires, we also assessed anxiety, depression, quality of life (QoL), general health symptoms, neuropathic pain, self-reported opioid consumption, and adverse events. RESULTS: Of the 1,000 patients consented, 757 (76%) participated at one or more of the study time points. At six and 12 months, 230 (30.4%) and 104 (13.7%) of participants were followed up, respectively. Most participants were female (62%), Caucasian (91%), and sought cannabis for pain relief (88%). Time was a significant factor associated with improvement in pain intensity (P < 0.001), pain-related interference scores (P < 0.001), QoL (P < 0.001), and general health symptoms (P < 0.001). Female sex was significantly associated with worse outcomes than male sex including pain intensity (P < 0.001) and pain-related interference (P < 0.001). The proportion of individuals who reported using opioids decreased by half, from 40.8% at baseline to 23.9% at 12 months. CONCLUSION: Despite significant challenges to collecting long-term observational data on patients who attempted a trial of cannabis products, approximately one-third of patients in the cohort remained on medical cannabis for six months. In this cohort, pain intensity and pain-related interference scores were reduced and QoL and general health symptoms scores were improved compared with baseline.
Authors: Calypse B Agborsangaya; Markus Lahtinen; Tim Cooke; Jeffrey A Johnson Journal: Health Qual Life Outcomes Date: 2014-05-16 Impact factor: 3.186
Authors: Lisa M Boucher; Esther S Shoemaker; Clare E Liddy; Lynne Leonard; Paul A MacPherson; Justin Presseau; Alana Martin; Dave Pineau; Christine Lalonde; Nic Diliso; Terry Lafleche; Michael Fitzgerald; Claire E Kendall Journal: Qual Health Res Date: 2022-03-24