UK Medical Cannabis Registry palliative care patients cohort: initial experience and outcomes

Journal of Cannabis Research

Oliver Salazar¹  Katerina Loupasaki¹  Mehmet Ergisi¹  Michael Harris¹  Rayyan Ali¹  Devaki Nimalan¹  Michal Kawka¹  Simon Erridge²  Michael Platt²  Mikael H. Sodergren²  Carl Holvey³  James J. Rucker⁴  Shaheen Khan⁵  Ross Coomber⁶ 

[1] Department of Surgery and Cancer, St Mary’s Hospital, Imperial College Medical Cannabis Research Group, Imperial College London, Academic Surgical Unit, 10th Floor QEQM, South Wharf Road, W2 1NY, London, UK;Department of Surgery and Cancer, St Mary’s Hospital, Imperial College Medical Cannabis Research Group, Imperial College London, Academic Surgical Unit, 10th Floor QEQM, South Wharf Road, W2 1NY, London, UK;Sapphire Medical Clinics, London, UK;Sapphire Medical Clinics, London, UK;Sapphire Medical Clinics, London, UK;Department of Psychological Medicine, Kings College London, London, UK;South London & Maudsley NHS Foundation Trust, London, UK;Sapphire Medical Clinics, London, UK;Guy’s & St. Thomas’ NHS Foundation Trust, London, UK;Sapphire Medical Clinics, London, UK;St. George’s Hospital NHS Trust, London, UK;

关键词: Cannabinoids;    Medical cannabis;    Health-related quality-of-life;    Palliative care;   

DOI  :  10.1186/s42238-021-00114-9

来源: Springer

【 摘 要 】

IntroductionPalliative care aims to improve quality of life through optimal symptom control and pain management. Cannabis-based medicinal products (CBMPs) have a proven role in the treatment of chemotherapy-induced nausea and vomiting. However, there is a paucity of high-quality evidence with regards to the optimal therapeutic regimen, safety, and effectiveness of CBMPs in palliative care, as existing clinical trials are limited by methodological heterogeneity. The aim of this study is to summarise the outcomes of the initial subgroup of patients from the UK Medical Cannabis Registry who were prescribed CBMPs for a primary indication of palliative care, cancer pain and chemotherapy-induced nausea and vomiting, including effects on health-related quality of life and clinical safety.MethodsA case series from the UK Medical Cannabis Registry of patients, who were receiving CBMPs for the indication of palliative care was undertaken. The primary outcome consisted of changes in patient-reported outcome measures including EQ-5D-5L, General Anxiety Disorder-7 (GAD-7), Single-Item Sleep Quality Scale (SQS), Pain Visual Analog Scale (VAS) and the Australia-Modified Karnofsky Performance Scale at 1 and 3 months compared to baseline. Secondary outcomes included the incidence and characteristics of adverse events. Statistical significance was defined by p-value< 0.050.ResultsSixteen patients were included in the analysis, with a mean age of 63.25 years. Patients were predominantly prescribed CBMPs for cancer-related palliative care (n = 15, 94%). The median initial CBD and THC daily doses were 32.0 mg (Range: 20.0–384.0 mg) and 1.3 mg (Range: 1.0–16.0 mg) respectively. Improvements in patient reported health outcomes were observed according to SQS, EQ-5D-5L mobility, pain and discomfort, and anxiety and depression subdomains, EQ-5D-5L index, EQ-VAS and Pain VAS validated scales at both 1-month and 3-months, however, the changes were not statistically significant. Three adverse events (18.75%) were reported, all of which were either mild or moderate in severity.ConclusionThis small study provides an exploratory analysis of the role of CBMPs in palliative care in the first cohort of patients since CBMPs legalisation in the UK. CBMPs were tolerated with few adverse events, all of which were mild or moderate and resolved spontaneously. Further long-term safety and efficacy studies involving larger cohorts are needed to establish CBMPs role in palliative care, including comparisons with standard treatments.

【 授权许可】

CC BY