College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Addiction. 2019 Oct;114(10):1791-1799. doi: 10.1111/add.14719. Epub 2019 Jul 19.
To estimate prevalence of continuous use (persistence) of prescribed cannabinoid medications for up to 1 year from initial prescription in Manitoba, Canada and predictors of duration of use.
A retrospective, population-based, cohort study using administrative data from the Manitoba Population Research Data Repository located at the Manitoba Centre for Health Policy, Canada.
People without a record of a previous prescription who were prescribed a cannabinoid medication from 1 April 2004 to 1 April 2016 followed for 1 year from the date of first prescription.
Continuous prescribed cannabinoid medication use was defined as use without a gap exceeding 60 days between prescriptions. The primary outcome was prevalence of continuous prescribed cannabinoid medication use for up to 1 year. A secondary outcome was duration of continuous use. Predictors were socio-demographic characteristics, medical diagnoses and type of cannabinoid medication.
Among 5452 new users, 18.1% [95% confidence interval (CI) = 17.08-19.12] were still using cannabinoids at 1 year. Median duration of use was 31 days [interquartile range (IQR) = 25-193]. This was highest for nabilone (33 days, IQR = 25-199) and lowest for nabiximols (20 days, IQR = 7-30). Use was longest among 19-45- and 46-64-year-old users and those with the highest socio-economic status. Fibromyalgia [hazard ratio (HR) = 0.89, 95% CI = 0.84-0.95], osteoarthritis (HR = 0.91, 95% CI = 0.82-0.97) and substance use disorder (HR = 0.85, 95% CI = 0.76-0.94) diagnoses were associated with longer use (HR for discontinuation-HR < 1 less discontinuation and longer use). A diagnosis of cancer was associated with shorter use (HR = 2.73, 95% CI = 2.02-3.67).
In Manitoba, Canada approximately 18% of people prescribed cannabinoid medication continue using for at least 1 year. Duration of use varies with type of cannabinoid medication, age, socio-economic status and dagnosis.
本研究旨在估计在加拿大马尼托巴省，从初始处方开始，在 1 年内持续使用（持续性）规定的大麻素药物的患病率，并预测使用时间的长短。
这是一项回顾性、基于人群的队列研究，使用了来自加拿大马尼托巴省卫生政策中心的马尼托巴人口研究数据存储库的管理数据。
无先前处方记录的人群，在 2004 年 4 月 1 日至 2016 年 4 月 1 日期间首次处方大麻素药物后，随访 1 年。
持续规定的大麻素药物使用被定义为没有超过 60 天的处方间隔的使用。主要结果是在 1 年内持续规定的大麻素药物使用的患病率。次要结果是持续使用的时间。预测因素是社会人口统计学特征、医疗诊断和大麻素药物的类型。
在 5452 名新使用者中，18.1%（95%置信区间[CI]：17.08-19.12）在 1 年内仍在使用大麻素。中位使用时间为 31 天（IQR：25-193）。其中，纳布酮的使用时间最长（33 天，IQR：25-199），纳比西莫司的使用时间最短（20 天，IQR：7-30）。19-45 岁和 46-64 岁的使用者以及社会经济地位最高的使用者使用时间最长。纤维肌痛（HR：0.89，95%CI：0.84-0.95）、骨关节炎（HR：0.91，95%CI：0.82-0.97）和物质使用障碍（HR：0.85，95%CI：0.76-0.94）诊断与更长的使用时间相关（停药 HR 比小于 1 表示停药和使用时间延长）。癌症诊断与使用时间缩短相关（HR：2.73，95%CI：2.02-3.67）。
在加拿大马尼托巴省，大约有 18%的人开大麻素药物处方后至少使用 1 年。使用时间的长短因大麻素药物的类型、年龄、社会经济地位和诊断而异。
