Department of Community Health and Health Behavior, University at Buffalo, Buffalo, New York, USA.
University of Maryland School of Medicine, Baltimore, Maryland, USA.
Cannabis Cannabinoid Res. 2021 Dec;6(6):548-558. doi: 10.1089/can.2019.0096. Epub 2020 Jun 8.
Despite widespread legalization, the impact of medicinal cannabis use on patient-level health and quality of life (QOL) has not been carefully evaluated. The objective of this study was to characterize self-reported demographics, health characteristics, QOL, and health care utilization of Cannabis Users compared with Controls. A longitudinal, cross-sectional web-based survey study was completed between April 2016 and February 2018. Study participants (=1276) were a convenience sample of either patients with a diagnosed health condition or caregivers of a patient with a diagnosed health condition registered with the Realm of Caring Foundation (a nonprofit organization dedicated to therapeutic cannabis research and education). Participants were invited through e-mail to complete follow-up assessments every 3 months with 33% of participants completing one or more prospective follow-ups. Assessments included self-reported demographics, health care utilization, medication use, pain, anxiety, depression, sleep, and QOL. Cannabis Users (=808) were compared with Controls (=468) using negative binomial regression and linear mixed effects models testing the effect of initiation, cessation, and maintenance of medicinal cannabis use. Cannabis Users self-reported significantly better QOL [(1054)=-4.19, <0.001], greater health satisfaction [(1045)=-4.14, <0.001], improved sleep [children: (224)=2.90, <0.01; adults: [(758)=3.03, <0.01], lower average pain severity [(1150)=2.34, <0.05], lower anxiety [(1151)=4.38, <0.001], and lower depression [(1210)=5.77, <0.001] compared with Controls. Cannabis Users reported using fewer prescription medications (rate ratio [RR]=0.86; 95% confidence interval [CI]: 0.77-0.96) and were less likely to have a past-month emergency department visit (RR=0.61; 95% CI: 0.44-0.84) or hospital admission (RR=0.54; 95% CI: 0.34-0.87). Controls who initiated cannabis use after baseline showed significant health improvements at follow-up, and the magnitude of improvement mirrored the between-group differences observed at baseline. Cannabis use was associated with improved health and QOL. Longitudinal testing suggests that group differences may be due to the medicinal use of cannabis. Although bias related to preexisting beliefs regarding the health benefits of cannabis in this sample should be considered, these findings indicate that clinical trials evaluating the efficacy of defined cannabinoid products for specific health conditions are warranted.
尽管医用大麻已广泛合法化，但人们对其使用对患者健康和生活质量（QOL）的影响尚未进行仔细评估。本研究旨在描述与对照者相比，大麻使用者自我报告的人口统计学、健康特征、QOL 和医疗保健利用情况。这是一项 2016 年 4 月至 2018 年 2 月期间进行的纵向、横断面网络调查研究。研究参与者（=1276）是 Realm of Caring 基金会（一家致力于治疗性大麻研究和教育的非营利组织）注册的已诊断健康状况的患者或患者的护理人员的便利样本。通过电子邮件邀请参与者每 3 个月完成一次后续评估，其中 33%的参与者完成了一次或多次前瞻性随访。评估包括自我报告的人口统计学、医疗保健利用、药物使用、疼痛、焦虑、抑郁、睡眠和 QOL。使用负二项回归和线性混合效应模型比较大麻使用者（=808）和对照组（=468），测试药用大麻使用的起始、停止和维持对 QOL 的影响。大麻使用者自我报告的 QOL 显著改善[（1054）=-4.19，<0.001]，健康满意度更高[（1045）=-4.14，<0.001]，睡眠质量提高[儿童：（224）=2.90，<0.01；成人：（758）=3.03，<0.01]，平均疼痛严重程度降低[（1150）=2.34，<0.05]，焦虑程度降低[（1151）=4.38，<0.001]，抑郁程度降低[（1210）=5.77，<0.001]。与对照组相比，大麻使用者报告使用的处方药较少（率比[RR]=0.86；95%置信区间[CI]：0.77-0.96），过去一个月内急诊就诊的可能性较小（RR=0.61；95%CI：0.44-0.84）或住院（RR=0.54；95%CI：0.34-0.87）。对照组在基线后开始使用大麻，在随访时健康状况显著改善，并且改善幅度与基线时观察到的组间差异相匹配。大麻的使用与健康和 QOL 的改善有关。纵向测试表明，组间差异可能是由于医用大麻的使用。尽管应该考虑到该样本中与大麻健康益处的先入为主的观念相关的偏见，但这些发现表明，有必要评估特定健康状况的定义大麻素产品的疗效的临床试验。
