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Introduction to the Arkell et al. Medical Cannabis Study
This article distills the primary conclusions and implications of a recent study by Arkell et al., published in JAMA Network Open, focusing on the positive impact of medical cannabis on health-related quality of life. The research included data from 3148 patients who used medical cannabis for a variety of health conditions over a 12-month period.
Prescribed Conditions for Medical Cannabis
The majority of patients were prescribed medical cannabis for chronic noncancer pain (68.6%), followed by cancer pain (6.0%), insomnia (4.8%), and anxiety (4.2%).
Measuring Health-Related Quality of Life: The SF-36 Health Survey
The 36-Item Short Form Health Survey (SF-36), a widely used tool that assesses eight different aspects of health, was utilized to measure health-related quality of life. These domains include physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health.
The research demonstrated that patients utilizing medical cannabis reported significant improvements in all SF-36 domains over time. The most significant improvements were seen in bodily pain, general health, and role-physical (measuring the extent to which physical health problems impact work and other daily activities). Patients who used balanced or CBD-dominant cannabis products experienced greater improvements compared to those who used THC-dominant products. The findings suggest that medical cannabis can positively influence health-related quality of life for patients with various conditions, particularly those suffering from chronic pain.
Strengths and Weaknesses of the Arkell et al. 2023 Study
Strengths of the Study:
- The study leveraged a large and diverse sample of patients who were prescribed medical cannabis for a range of conditions, including chronic pain, cancer, epilepsy, multiple sclerosis, posttraumatic stress disorder, and anxiety.
- The SF-36, a validated and widely used tool, was used to measure health-related quality of life, encompassing both physical and mental aspects of well-being.
- Longitudinal data and repeated measures analysis were employed to investigate changes in health-related quality of life over time and to account for individual differences and confounding factors.
- Potential confounders such as age, sex, education level, employment status, marital status, baseline diagnosis, symptom severity, medication use, and cannabis use at baseline were controlled for.
Weaknesses of the Study:
- The observational nature of the study limits the ability to infer causality and generalize results.
- The study relied on self-reported data from patients, which may be prone to recall bias, social desirability bias, or reporting errors.
- The actual dose or consumption of medical cannabis by patients was not measured, which can vary depending on the product type, administration method, frequency of use, and individual factors.
- The study did not evaluate the adverse effects or safety of medical cannabis use, which could influence health-related quality of life.
Key Findings: Medical Cannabis and Quality of Life Improvement
All 8 domains of the SF-36 were statistically improved (p=<0.001 ***). The following table summarizes the study’s key findings:
Implications and Conclusions: The Impact of Medical Cannabis on Chronic Pain Patients
The study offers evidence that medical cannabis use could enhance health-related quality of life for patients with diverse conditions over time, particularly those with chronic pain. It also suggests that balanced or CBD-dominant cannabis products may provide greater benefits than THC-dominant products. However, it’s crucial to note that the study design doesn’t allow for definitive causality between medical cannabis use and improvements in health-related quality of life.
The significant improvements in all domains of SF-36 scores indicate that medical cannabis treatment can substantially improve the health-related quality of life for patients with chronic pain. This is especially pertinent since chronic pain patients often start with low SF-36 scores, denoting a lower quality of life.
While 2919 adverse events were reported throughout the year-long study, only two were deemed serious, implying a low risk of severe harm. This risk profile is particularly favorable when compared to the adverse event profiles of opioid-based pharmaceuticals.
Hence, for many patients suffering from chronic pain, the potential benefits of medical cannabis treatment in terms of improved quality of life may outweigh the risks, particularly if their pain isn’t well-managed with other treatments and their quality of life is significantly impaired.
To summarize, this study lends support to the potential of medical cannabis as a promising treatment option for improving health-related quality of life, especially for patients battling chronic pain. Further research, however, is needed to ascertain that chronic, long-term effects of medical cannabis use remains effective and safe.
Stefan Broselid, Ph.D.
Editor-In-Chief, Aurea Care Medical Science Journal
Reference:
Arkell TR, Downey LA, Hayley AC, Roth S. Assessment of Medical Cannabis and Health-Related Quality of Life. JAMA Netw Open. 2023;6(5):e2312522. doi:10.1001/jamanetworkopen.2023.12522