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评估加拿大医用大麻患者调查中患者报告的大麻安全性和疗效。

Evaluation of Patient Reported Safety and Efficacy of Cannabis From a Survey of Medical Cannabis Patients in Canada.

机构信息

Aurora Cannabis Inc., Edmonton, AB, Canada.

Department of Botany, University of British Columbia, Vancouver, BC, Canada.

出版信息

Front Public Health. 2021 May 20;9:626853. doi: 10.3389/fpubh.2021.626853. eCollection 2021.

Abstract

With the medical use of cannabis permitted in Canada since 2001, patients seek to use this botanical drug to treat a range of medical conditions. However, many healthcare practitioners express the need for further scientific evidence around the use of medical cannabis. This real-world evidence study aimed to address the paucity of scientific data by surveying newly registered medical cannabis patients, before beginning medical cannabis treatment, and at one follow up 6 weeks after beginning medical cannabis treatment. The goal was to collect data on efficacy, safety and cannabis product type information to capture the potential impact medical cannabis had on patient-reported quality of life (QOL) and several medical conditions over a 6-week period using validated questionnaires. The 214 participants were mainly male (58%) and 57% of the population was older than 50. The most frequently reported medical conditions were recurrent pain, post-traumatic stress disorder (PTSD), anxiety, sleep disorders [including restless leg syndrome (RLS)], and arthritis and other rheumatic disorders. Here we report that over 60% of our medical cannabis cohort self-reported improvements in their medical conditions. With the use of validated surveys, we found significant improvements in recurrent pain, PTSD, and sleep disorders after 6 weeks of medical cannabis treatment. Our findings from patients who reported arthritis and other rheumatic disorders are complex, showing improvements in pain and global activity sub-scores, but not overall changes in validated survey scores. We also report that patients who stated anxiety as their main medical condition did not experience significant changes in their anxiety after 6 weeks of cannabis treatment, though there were QOL improvements. While these results show that patients find cannabis treatment effective for a broad range of medical conditions, cannabis was not a remedy for all the conditions investigated. Thus, there is a need for future clinical research to support the findings we have reported. Additionally, while real-world evidence has not historically been utilized by regulatory bodies, we suggest changes in public policy surrounding cannabis should occur to reflect patient reported efficacy of cannabis from real-world studies due to the uniqueness of medical cannabis's path to legalization.

摘要

自 2001 年以来,加拿大已允许将医用大麻用于医疗用途,患者希望使用这种植物药物来治疗一系列医疗病症。然而,许多医疗保健从业者表示需要更多关于医用大麻使用的科学证据。这项真实世界证据研究旨在通过调查新注册的医用大麻患者,在开始医用大麻治疗之前,以及在开始医用大麻治疗后 6 周进行一次随访,来解决科学数据不足的问题。目的是收集疗效、安全性和大麻产品类型信息的数据,以利用经过验证的问卷在 6 周内捕捉医用大麻对患者报告的生活质量(QOL)和几种医疗病症的潜在影响。214 名参与者主要为男性(58%),57%的人群年龄大于 50 岁。报告的最常见医疗病症是复发性疼痛、创伤后应激障碍(PTSD)、焦虑、睡眠障碍[包括不宁腿综合征(RLS)]和关节炎及其他风湿性疾病。在这里,我们报告说,我们的医用大麻队列中超过 60%的患者自我报告他们的医疗病症有所改善。使用经过验证的调查,我们发现经过 6 周的医用大麻治疗后,复发性疼痛、PTSD 和睡眠障碍显著改善。我们对报告关节炎和其他风湿性疾病的患者的发现较为复杂,疼痛和整体活动子评分有所改善,但经过验证的调查评分没有总体变化。我们还报告说,报告焦虑为主要医疗病症的患者在接受 6 周大麻治疗后,其焦虑症状并未出现显著变化,但生活质量有所改善。虽然这些结果表明患者发现大麻治疗对广泛的医疗病症有效,但大麻并非治疗所有调查病症的方法。因此,需要进行未来的临床研究来支持我们报告的发现。此外,尽管真实世界的证据在历史上并未被监管机构利用,但我们建议对围绕大麻的公共政策进行修改,以反映真实世界研究中患者报告的大麻疗效,因为医用大麻的合法化途径具有独特性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51a7/8172603/507ce14662c1/fpubh-09-626853-g0001.jpg

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