Assessing health-related quality of life in patients accessing medicinal cannabis

Abstract

There is growing interest worldwide in using medicinal cannabis (MC) to manage symptoms and side-effects of chronic health conditions when conventional therapies fail. Although many countries allow MC, barriers to accessing prescriptions persist due to historical legal restrictions on cannabis use and the subsequent delay in developing a therapy-focused evidence-base. A patient-centred approach to healthcare requires patient-reported outcome (PRO) evidence. Health-related quality of life (HRQL) is a widely assessed and important outcome for patients with chronic conditions. This mixed methods thesis contains a series of studies aimed to contribute to the evidence-base by assessing HRQL and the experiences of patients prescribed MC. A literature review explored how HRQL is assessed in this cohort, along with a meta-analysis of findings from the past decade. Following a published protocol, a nation-wide prospective study quantitatively assessed short-, and long-term HRQL and other PROs in patients newly prescribed MC. Finally, patients were interviewed and their experiences after being prescribed MC long-term explored using qualitative methods.

The findings from this research demonstrated that patients with chronic health conditions prescribed MC had significant and clinically meaningful improvements in HRQL and reduced their dependence on conventional medicines. Despite the potential benefits from MC, conflicting regulations and barriers to accessing MC persist and should be addressed with an evidence-informed patient-centred care approach.

Incorporating MC evidence into clinical guidelines, policy, and education, can potentially reduce the economic burden and patient suffering caused by chronic conditions and problematic conventional treatments, while also reducing the risk of harm from self-medicating. Future research looking at the economic impact of prescribing MC for chronic health conditions is recommended.