Study register · detailKohortenstudie · Rheumatoid Arthritis · 2020
Medical Cannabis Use by Rheumatology Patients Following Recreational Legalization: A Prospective Observational Study of 1000 Patients in Canada
Fitzcharles et al.·ACR Open RheumatologyImpact 1.8
UnclearGRADELow35 citations
Samplen = 1.000 Pat.
DurationJune to August 2019
EndpointPrevalence of medical…
Blindingn.a.
DesignKohortenstudie
”Key finding
12,6% of patients reported medical cannabis use; about half continued use, mainly for pain relief; 57% of users discontinued due to lack of effect, 28% due to side effects.
Summary
n=1.000 rheumatology patients (RA, OA, fibromyalgia) following cannabis legalisation in Canada; 51% reported cannabis use, most common motives: pain reduction (71%) and sleep improvement (50%); no intervention data, pure prevalence survey.
P
PopulationRheumatology patients in Canada following legalisation of recreational cannabis, n=1000, consecutively recruited
I
InterventionMedical cannabis (various forms of administration: smoking, vaporising, oral oils)
O
OutcomePrevalence of medical cannabis use 12,6% (95% CI 10,7-14,8%), tripling since legalisation; 50% continuation for pain relief; discontinuation in 57% due to lack of effectiveness, in 28% due to side effects
Confidence in the evidence
Very lowLowModerateHigh
Low
The second of four GRADE levels, the effect estimate is of limited reliability.
Objective: Recreational legalization of cannabis may influence the medical use by patients. When only medical access was legally available in Canada, 4.3% of rheumatology patients reported use. With the current recreational legalization, we have reexamined the prevalence and characteristics of medical cannabis use in this same rheumatology setting.
Methods: Consecutively attending rheumatology patients participated in an onsite survey comprising the following two questionnaires: 1) demographic and disease information completed by the rheumatologist and 2) patient anonymous questionnaire of health status, cannabis use (recreational and/or medicinal), and characteristics of cannabis use.
Results: Of 1047 attendees from June to August 2019, with 1000 participating, medical cannabis had been used by 12.6% of patients (95% confidence interval 10.7%-14.8%), with half continuing use for mostly pain relief. Discontinuation was due to lack of effect in 57% of patients and side effects in 28% of patients. Ever medical users were younger (61.2 vs. 64.9 years; P = 0.006), more likely unemployed/disabled (16.7% vs. 5.9%; P < 0.001), and had more previous (47.6% vs. 25.5%; P < 0.001) and current recreational cannabis use (17.5% vs. 3.1%; P < 0.001) than nonusers. Most patients used multiple methods of administration, including smoking, vaporizing, and using oral oil preparations, but were poorly knowledgeable of product content, which was bought solely via the legal medical route by only 20%, and only one-third disclosed their use to the rheumatologist.
Conclusion: Medical cannabis use has tripled for rheumatology patients since recreational legalization, with users being younger, not working, and having recreational cannabis experience. Concerning issues are the poor knowledge of the product being used, access via the nonmedical route, and nondisclosure to the physician. on behalf of American College of Rheumatology.