Tait Margaret-Ann, Costa Daniel S J, Campbell Rachel, Norman Richard, Schug Stephan, Rutherford Claudia
School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia.
School of Population Health, Curtin University, Perth, Australia.
JMIR Res Protoc. 2021 Nov 24;10(11):e32327. doi: 10.2196/32327.
Evidence supports several countries introducing legislation to allow cannabis-based medicine as an adjunctive treatment for the symptomatic relief of chronic pain, chemotherapy-induced nausea, spasticity in multiple sclerosis (MS), epileptic seizures, depression, and anxiety. However, clinical trial participants do not represent the entire spectrum of disease and health status seen in patients currently accessing medicinal cannabis in practice.
This study aims to collect real-world data to evaluate health-related quality of life in patients prescribed medicinal cannabis oil and describe any differences over time, from before starting therapy to after 3 and 12 months of therapy.
Adult patients newly prescribed medicinal cannabis oil by authorized prescribers and under the Special Access Schemes across Australia will be screened for eligibility and invited to participate. A sample size of 2142 is required, with a 3-month follow-up. All participants will complete the EuroQol 5-Dimension; European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-30; Depression, Anxiety, and Stress Scale-21; Patients' Global Impression of Change; Patient-Reported Outcomes Measurement Information System (PROMIS) Short Form (SF) version 1.0: Sleep Disturbance 8b; and PROMIS SF Fatigue 13a questionnaires. Patients with chronic pain conditions will also complete the PROMIS SF version 1.0: Pain Intensity 3a and PROMIS SF version 1.0: Pain Interference 8a. Patients with movement disorders will also complete Quality of Life in Neurological Disorders (Neuro-QoL) SF version 1.0: Upper Extremity Function (Fine Motor and Activities of Daily Living) and if chorea is indicated, the Neuro-QoL SF version 2.0: Huntington's Disease health-related Quality of LIFE-Chorea 6a. All questionnaires will be administered at baseline, 2 weeks (titration), monthly up to 3 months, and then every 2 months up to 1 year.
Recruitment commenced in November 2020. By June 2021, 1095 patients were screened for the study by 69 physicians in centers across 6 Australian states: Australian Capital Territory, New South Wales, Queensland, South Australia, Victoria, and Western Australia. Of the patients screened, 833 (39% of the target sample size) provided consent and completed baseline questionnaires. Results are expected to be published in 2022. Results of this study will show whether patient-reported outcomes improve in patients accessing prescribed medicinal cannabis from baseline to 3 months and whether any changes are maintained over a 12-month period. This study will also identify differences in improvements in patient-reported outcomes among patients with different chronic conditions (eg, chronic pain, MS, epilepsy, Parkinson disease, or cancer).
This protocol contains detailed methods that will be used across multiple sites in Australia. The findings from this study have the potential to be integral to treatment assessment and recommendations for patients with chronic pain and other health indicators for accessing medicinal cannabis.
Australian New Zealand Clinical Trials Registry: ANZCTRN12621000063819; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380807&isReview=true.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/32327.
有证据支持多个国家出台立法,允许将大麻类药物作为辅助治疗手段,用于缓解慢性疼痛、化疗引起的恶心、多发性硬化症(MS)的痉挛、癫痫发作、抑郁和焦虑等症状。然而,临床试验参与者并不能代表目前实际使用药用大麻的患者的全部疾病和健康状况范围。
本研究旨在收集真实世界数据,以评估开具药用大麻油处方的患者的健康相关生活质量,并描述从开始治疗前到治疗3个月和12个月后随时间的任何差异。
将对澳大利亚各地经授权的开方者根据特殊准入计划新开具药用大麻油处方的成年患者进行资格筛查并邀请其参与。需要2142名样本量,并进行3个月的随访。所有参与者将完成欧洲五维健康量表;欧洲癌症研究与治疗组织生活质量问卷-30;抑郁、焦虑和压力量表-21;患者总体变化印象;患者报告结局测量信息系统(PROMIS)简表(SF)1.0版:睡眠障碍8b;以及PROMIS SF疲劳13a问卷。患有慢性疼痛疾病的患者还将完成PROMIS SF 1.0版:疼痛强度3a和PROMIS SF 1.0版:疼痛干扰8a。患有运动障碍的患者还将完成神经疾病生活质量(Neuro-QoL)SF 1.0版:上肢功能(精细运动和日常生活活动),如果有舞蹈症指征,则完成Neuro-QoL SF 2.0版:亨廷顿舞蹈病健康相关生活质量-舞蹈症6a。所有问卷将在基线、2周(滴定期)、直至3个月每月进行一次发放,然后直至1年每2个月进行一次发放。
招募工作于2020年11月开始。截至2021年6月,澳大利亚6个州(澳大利亚首都直辖区、新南威尔士州、昆士兰州、南澳大利亚州、维多利亚州和西澳大利亚州)的69名医生在各中心对1095名患者进行了该研究的筛查。在筛查的患者中,833名(占目标样本量的39%)提供了同意并完成了基线问卷。预计结果将于2022年发表。本研究结果将显示,从基线到3个月,使用处方药用大麻的患者报告结局是否有所改善,以及在12个月期间是否维持任何变化。本研究还将确定不同慢性病(如慢性疼痛、MS、癫痫、帕金森病或癌症)患者在患者报告结局改善方面的差异。
本方案包含将在澳大利亚多个地点使用的详细方法。本研究的结果可能对慢性疼痛患者及其他健康指标患者获取药用大麻的治疗评估和建议不可或缺。
澳大利亚新西兰临床试验注册中心:ANZCTRN12621000063819;https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380807&isReview=true。
国际注册报告识别码(IRRID):DERR1-10.2196/32327。