UK medical cannabis registry: A clinical outcome analysis of medical cannabis therapy in chronic pain patients with and without co-morbid sleep impairment.

Autor: Datta I; Department of Surgery and Cancer, Medical Cannabis Research Group, Imperial College London, London, UK., Erridge S; Department of Surgery and Cancer, Medical Cannabis Research Group, Imperial College London, London, UK.; Curaleaf Clinic, London, UK., Holvey C; Curaleaf Clinic, London, UK., Coomber R; Curaleaf Clinic, London, UK.; St. George's Hospital NHS Trust, London, UK., Guru R; Curaleaf Clinic, London, UK.; Cardiff and Vale University Health Board, Cardiff, UK., Holden W; Curaleaf Clinic, London, UK., Darweish Medniuk A; Curaleaf Clinic, London, UK.; Southmead Hospital, North Bristol NHS Trust, Bristol, UK., Sajad M; Curaleaf Clinic, London, UK., Searle R; Curaleaf Clinic, London, UK., Usmani A; Curaleaf Clinic, London, UK., Varma S; Curaleaf Clinic, London, UK., Rucker JJ; Curaleaf Clinic, London, UK.; Department of Psychological Medicine, Kings College London, London, UK.; South London and Maudsley NHS Foundation Trust, London, UK., Platt M; Curaleaf Clinic, London, UK., Sodergren MH; Department of Surgery and Cancer, Medical Cannabis Research Group, Imperial College London, London, UK.; Curaleaf Clinic, London, UK.
Jazyk: angličtina
Zdroj: Pain practice : the official journal of World Institute of Pain [Pain Pract] 2024 Nov 15. Date of Electronic Publication: 2024 Nov 15.
DOI: 10.1111/papr.13438
Abstrakt: Introduction: Chronic pain (CP) affects 35.0%-51.3% of the UK population, with 67%-88% reporting sleep disturbances. Cannabis-based medicinal products (CBMPs) have shown therapeutic potential in managing CP. Evidence suggests poor sleep worsens pain perception; therefore, this study aimed to assess patient-reported outcome measures (PROMs) following CBMP treatment in CP patients with and without co-morbid sleep impairment.
Methods: A prospective cohort study of CP patients from the UK Medical Cannabis Registry was conducted. Participants were separated by baseline single-item sleep quality scale (SQS) score into sleep impaired (SQS ≤3) and unimpaired (SQS ≥4) cohorts. The primary outcome assessed changes in PROMs from baseline to 1-, 3-, 6-, and 12-months. Participants completed the following: SQS, General Anxiety Disorder-7, EQ-5D-5L, Brief Pain Inventory (BPI), and Short-Form McGill Pain Questionnaire-2. Significance was defined as p < 0.050.
Results: 1139 participants met the inclusion criteria (sleep impaired: n = 517, 45.4%; sleep unimpaired: n = 622, 54.61%). The sleep impaired cohort showed improvements in all PROMs at each follow-up (p < 0.010). The sleep unimpaired cohort showed similar results (p < 0.050), except in SQS and ED-5Q-5L: self-care and anxiety/depression scores (p > 0.050). However, the sleep impaired cohort observed greater improvements in BPI pain severity (p < 0.050) and SQS (p < 0.001) than the sleep unimpaired cohort at all follow-ups. 2817 adverse events were self-reported between both cohorts (p = 0.197).
Discussion: These findings align with literature that shows associated improvements in pain outcomes following CBMP administration. Sleep impaired individuals were more likely to experience greater pain severity improvements. However, this was not confirmed on multivariate logistic regression analysis and instead may be confounded by baseline pain severity.
Conclusion: Whilst these results show promise for the effects of CBMPs on CP, they must be examined within the limitations of the study design. These findings provide further evidence to support the design of subsequent randomized controlled trials to verify causality between CBMPs and pain outcomes.
(© 2024 The Author(s). Pain Practice published by Wiley Periodicals LLC on behalf of World Institute of Pain.)
Databáze: MEDLINE
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