Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.
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.
Can J Anaesth. 2021 May;68(5):633-644. doi: 10.1007/s12630-020-01903-1. Epub 2021 Jan 20.
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.
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.
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.
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.
我们调查了寻求医用大麻的慢性疼痛患者。我们评估了他们的人口统计学特征、大麻使用模式，以及大麻对他们疼痛和功能领域的长期效果。
这项观察性研究于 2015 年 9 月 8 日至 2018 年 7 月 31 日期间在加拿大安大略省的社区大麻诊所招募患者。除了收集人口统计学信息外，主要研究结果是在基线、3 个月、6 个月和 12 个月时评估的疼痛强度和与疼痛相关的干扰评分。我们还使用经过验证的问卷评估了焦虑、抑郁、生活质量（QoL）、一般健康症状、神经病理性疼痛、自我报告的阿片类药物使用量和不良事件。
在同意参与的 1000 名患者中，757 名（76%）患者参加了一个或多个研究时间点。在 6 个月和 12 个月时，分别有 230 名（30.4%）和 104 名（13.7%）参与者接受了随访。大多数参与者为女性（62%）、白种人（91%），并寻求大麻来缓解疼痛（88%）。时间是与疼痛强度（P<0.001）、与疼痛相关的干扰评分（P<0.001）、QoL（P<0.001）和一般健康症状（P<0.001）改善相关的显著因素。与男性相比，女性的性别与更差的结局显著相关，包括疼痛强度（P<0.001）和与疼痛相关的干扰（P<0.001）。报告使用阿片类药物的人数从基线时的 40.8%减少到 12 个月时的 23.9%，减少了一半。
尽管在收集尝试大麻产品的患者的长期观察数据方面存在重大挑战，但该队列中仍有约三分之一的患者在 6 个月后继续使用医用大麻。在该队列中，与基线相比，疼痛强度和与疼痛相关的干扰评分降低，QoL 和一般健康症状评分提高。
