Medical Cannabis Improves Patients’ Quality of Life, Study Finds

Medical cannabis treatment can have a significant positive effect on patients’ health-related quality of life, suggests an observational study from researchers at Swinburne University of Technology, Australia.

The study, published this month in JAMA Network Open, looked at patients enrolled in the Emerald Clinics network of medical cannabis clinics, which are located across Australia. From patient responses to health survey questionnaires, the researchers found that quality of life scores rose in all health-related domains after beginning medical cannabis treatment.

While serious adverse events were rare, the researchers did note that less serious symptoms were still frequently reported, suggesting that healthcare professionals should take care when prescribing medical cannabis products. However, based on this observational study of real-world data, the researchers believe that further clinical trials studying improvements to quality of life are warranted.

Medical cannabis improves all quality-of-life measures

The researchers assessed the health-related quality of life for more than 3,100 medical cannabis patients. This was done using the 36-item Short Form Health Survey (SF-36), a validated and widely used questionnaire to measure subjective quality of life.

More specifically, the SF-36 asks patients to rate various aspects of their life on a 0-100 scale across eight distinct areas, including: limitations in physical activity, social limitations, bodily pain, mental health concerns, vitality, and other general health concerns.

In this study, patients completed the SF-36 questionnaire at baseline before treatment, and then again at a series of up to 15 follow-up appointments held roughly one month apart.

The researchers found improvements in patient scores from baseline across all eight domains, ranging from between 6.6 to 18.3 points on average. A 10-point change is generally considered as being clinically important.

However, while changes of this magnitude likely feel significant to the individual patients concerned, the researchers do point out that the scores achieved with medical cannabis treatment were still well below the Australian average. As the researchers write, although their results suggest “substantial absolute gains across all functional domains”, it is still “important to contextualize the magnitude” of these changes.

Adverse events are rarely serious, but common

Examining the patient case data, the researchers found that CBD-dominant medical cannabis treatments accounted for around 80% of all monthly prescriptions; THC-dominant and THC and CBD-balanced products measured at 12.5% and 7.5% respectively. Oils made up more than 90% of the products being prescribed. Capsules were the next-most common, with small numbers of prescriptions also given out for dried flower, alone or in combination with another oil product.

Across all product types, the researchers found that medical cannabis treatments were safe and well tolerated, with very few serious adverse events reported.

However, less serious events were more frequent; more than 2,000 minor adverse effects were reported over the course of the study. Most commonly, these reports concerned sleepiness, dry mouth, lethargy, and dizziness. Rarer side effects included headaches, anxiety, vivid dreams, and one incidence of hallucination. It was determined that there were no significant associations seen between different product types or cannabinoid compositions and adverse effect risks.

Based on these findings, the researchers say that further research into medical cannabis treatment is warranted, as it appears to impart a meaningful positive effect on patient quality of life. However, as highlighted by the adverse effect data, they also say that prescribers at medical cannabis clinics should exercise caution and monitor patients carefully for any problematic side effects.

Cannabis and quality of life

In this observational study, the patient body was largely made up of those suffering with chronic non-cancer pain, followed by smaller numbers of patients receiving medical cannabis for cancer pain, insomnia, and anxiety.

Interestingly, other studies involving a broad range of qualifying conditions have also found evidence to back up the effectiveness of medical cannabis for patients.

T21 (Formerly Project Twenty21) is Europe’s largest medical cannabis patient registry. Initial study of its patients has suggested that medical cannabis can improve general patient health and quality of life, as assessed by the EQ-5D-5L quality of life questionnaire.

“On a measurement of 0-to-100, where 100 presents the best imaginable quality of life, the mean score for our T21 patients [when initiating treatment] was 46.8,” Dr. Anne Katrin Schlag, head of research at T21 organizer Drug Science, previously told Analytical Cannabis. “We compared our findings to normative data from the UK household population. Here, the mean was 85.7 – showing just how low quality of life is for our patients [at initiation of treatment].”

“Yet our three-month follow up data, albeit with a small sample size of 64 so far, shows that patients' quality of life improved significantly, from 46.8 to 63.3 – a 50% increase in self-reported quality of life, which indicates a large effect of CBMPs [cannabis-based medical products] for improved health.”

Outside of T21, a recent study of people with epilepsy who use non-prescription CBD products has suggested that they may also have a higher quality of life than their peers who do not use CBD products.

“We looked at a lot of important variables that are both epilepsy and seizure-related, and then also those that don’t receive as much attention in clinical trials or in the literature,” study author Dr. Nicolas Schlienz, told Analytical Cannabis following the study’s publication.

“We saw improvements in quality of life among epilepsy users. We also saw improvements to anxiety and depression and sleep. While those variables may not be the focus of clinical trials very often, you still want to see those improvements among these among any patients. Because if you don’t have those, then you would have epilepsy or seizures affecting a lower quality of life, making that even more difficult for the patient.”

But medical cannabis may not be the answer for everyone. One recent randomized, blinded, placebo-controlled trial of 144 patients with advanced cancer who were receiving palliative care found no significant improvements in patients’ ratings of pain, depression, anxiety, or quality of life after following a CBD oil regimen.