{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T11:15:55Z","timestamp":1787915755720,"version":"build-2784847793"},"reference-count":24,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>The use of cannabis as a medicine is becoming increasingly prevalent. Given the diverse range of conditions being treated with medical cannabis, as well as the vast array of products and dose forms available, clinical evidence incorporating patient-reported outcomes may help determine safety and efficacy.<\/jats:p><\/jats:sec>Objective<\/jats:title>To assess whether patients using medical cannabis report improvements in health-related quality of life over time.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This retrospective case series study was conducted at a network of specialist medical clinics (Emerald Clinics) located across Australia. Participants were patients who received treatment for any indication at any point between December 2018 and May 2022. Patients were followed up every mean (SD) 44.6 (30.1) days. Data for up to 15 follow-ups were reported. Statistical analysis was conducted from August to September 2022.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Medical cannabis. Product types and cannabinoid content varied over time in accordance with the treating physician\u2019s clinical judgement.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The main outcome measure was health-related quality of life as assessed using the 36-Item Short Form Health Survey (SF-36) questionnaire.<\/jats:p><\/jats:sec>Results<\/jats:title>In this case series of 3148 patients, 1688 (53.6%) were female; 820 (30.2%) were employed; and the mean (SD) age was 55.9 (18.7) years at baseline before treatment. Chronic noncancer pain was the most common indication for treatment (68.6% [2160 of 3148]), followed by cancer pain (6.0% [190 of 3148]), insomnia (4.8% [152 of 3148]), and anxiety (4.2% [132 of 3148]). After commencing treatment with medical cannabis, patients reported significant improvements relative to baseline on all 8 domains of the SF-36, and these improvements were mostly sustained over time. After controlling for potential confounders in a regression model, treatment with medical cannabis was associated with an improvement of 6.60 (95% CI, 4.57-8.63) points to 18.31 (95% CI, 15.86-20.77) points in SF-36 scores, depending on the domain (all P<\/jats:italic>\u2009&amp;lt;\u2009.001). Effect sizes (Cohen d<\/jats:italic>) ranged from 0.21 to 0.72. A total of 2919 adverse events were reported, including 2 that were considered serious.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this case series study, patients using medical cannabis reported improvements in health-related quality of life, which were mostly sustained over time. Adverse events were rarely serious but common, highlighting the need for caution with prescribing medical cannabis.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.12522","type":"journal-article","created":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T20:36:00Z","timestamp":1683664560000},"page":"e2312522","source":"Crossref","is-referenced-by-count":54,"title":["Assessment of Medical Cannabis and Health-Related Quality of Life"],"prefix":"10.1001","volume":"6","author":[{"given":"Thomas R.","family":"Arkell","sequence":"first","affiliation":[{"name":"Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke A.","family":"Downey","sequence":"additional","affiliation":[{"name":"Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Victoria, Australia"},{"name":"Institute for Breathing and Sleep (IBAS), Austin Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amie C.","family":"Hayley","sequence":"additional","affiliation":[{"name":"Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Victoria, Australia"},{"name":"Institute for Breathing and Sleep (IBAS), Austin Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Roth","sequence":"additional","affiliation":[{"name":"Department of Economics, University of Western Australia, Crawley, Western Australia, Australia"},{"name":"Emyria, Leederville, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,5,9]]},"reference":[{"key":"zoi230387r1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.885655","article-title":"Medicinal cannabis prescribing in australia: an analysis of trends over the first five years.","volume":"13","author":"MacPhail","year":"2022","journal-title":"Front Pharmacol"},{"issue":"1","key":"zoi230387r3","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1186\/s12916-022-02459-1","article-title":"Medical cannabinoids: a pharmacology-based systematic review and meta-analysis for all relevant medical indications.","volume":"20","author":"Bilbao","year":"2022","journal-title":"BMC Med"},{"issue":"24","key":"zoi230387r4","doi-asserted-by":"publisher","first-page":"2456","DOI":"10.1001\/jama.2015.6358","article-title":"Cannabinoids for medical use: a systematic review and meta-analysis.","volume":"313","author":"Whiting","year":"2015","journal-title":"JAMA"},{"key":"zoi230387r5","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.ejim.2018.01.003","article-title":"The therapeutic effects of cannabis and cannabinoids: an update from the National Academies of Sciences, Engineering and Medicine report.","volume":"49","author":"Abrams","year":"2018","journal-title":"Eur J Intern Med"},{"issue":"7","key":"zoi230387r6","doi-asserted-by":"publisher","first-page":"945","DOI":"10.7326\/M22-0217","article-title":"U.S. trends in registration for medical cannabis and reasons for use from 2016 to 2020: an observational study.","volume":"175","author":"Boehnke","year":"2022","journal-title":"Ann Intern Med"},{"issue":"5","key":"zoi230387r7","doi-asserted-by":"publisher","first-page":"1509","DOI":"10.1007\/s00213-021-06047-8","article-title":"Prevalence and self-reported reasons of cannabis use for medical purposes in USA and Canada.","volume":"239","author":"Leung","year":"2022","journal-title":"Psychopharmacology (Berl)"},{"issue":"1","key":"zoi230387r8","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1007\/s43441-021-00346-0","article-title":"Real world evidence in medical cannabis research.","volume":"56","author":"Banerjee","year":"2022","journal-title":"Ther Innov Regul Sci"},{"key":"zoi230387r9","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.1027159","article-title":"The value of real world evidence: The case of medical cannabis.","volume":"13","author":"Schlag","year":"2022","journal-title":"Front Psychiatry"},{"issue":"6","key":"zoi230387r10","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1097\/00005650-199206000-00002","article-title":"The MOS 36-item short-form health survey (SF-36). I. conceptual framework and item selection.","volume":"30","author":"Ware","year":"1992","journal-title":"Med Care"},{"issue":"5","key":"zoi230387r11","doi-asserted-by":"publisher","first-page":"350","DOI":"10.3109\/07853890109002089","article-title":"The RAND-36 measure of health-related quality of life.","volume":"33","author":"Hays","year":"2001","journal-title":"Ann Med"},{"issue":"1034","key":"zoi230387r12","doi-asserted-by":"publisher","first-page":"n1034","DOI":"10.1136\/bmj.n1034","article-title":"Medical cannabis or cannabinoids for chronic non-cancer and cancer related pain: a systematic review and meta-analysis of randomised clinical trials.","volume":"374","author":"Wang","year":"2021","journal-title":"BMJ"},{"issue":"1","key":"zoi230387r13","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1515\/jbnst-2020-0029","article-title":"The Household, Income and Labour Dynamics in Australia (HILDA) Survey.","volume":"241","author":"Watson","year":"2021","journal-title":"Jahrb Natl Okon Stat"},{"issue":"13","key":"zoi230387r14","doi-asserted-by":"publisher","first-page":"1883","DOI":"10.1080\/10826084.2022.2107673","article-title":"Medical cannabis patients report improvements in health functioning and reductions in opiate use.","volume":"57","author":"Pritchett","year":"2022","journal-title":"Subst Use Misuse"},{"issue":"11","key":"zoi230387r15","doi-asserted-by":"publisher","first-page":"3073","DOI":"10.1093\/pm\/pnaa163","article-title":"Medical Cannabis for the Management of Pain and Quality of Life in Chronic Pain Patients: A Prospective Observational Study.","volume":"21","author":"Safakish","year":"2020","journal-title":"Pain Med"},{"issue":"12","key":"zoi230387r16","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1097\/AJP.0000000000000364","article-title":"The Effect of Medicinal Cannabis on Pain and Quality-of-Life Outcomes in Chronic Pain: A Prospective Open-label Study.","volume":"32","author":"Haroutounian","year":"2016","journal-title":"Clin J Pain"},{"issue":"4","key":"zoi230387r17","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1080\/17512433.2022.2017771","article-title":"UK Medical Cannabis registry: an analysis of clinical outcomes of medicinal cannabis therapy for chronic pain conditions.","volume":"15","author":"Harris","year":"2022","journal-title":"Expert Rev Clin Pharmacol"},{"key":"zoi230387r18","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.626853","article-title":"Evaluation of Patient Reported Safety and Efficacy of Cannabis From a Survey of Medical Cannabis Patients in Canada.","volume":"9","author":"Cahill","year":"2021","journal-title":"Front Public Health"},{"key":"zoi230387r19","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.613805","article-title":"Prolonged medical cannabis treatment is associated with quality of life improvement and reduction of analgesic medication consumption in chronic pain patients.","volume":"12","author":"Aviram","year":"2021","journal-title":"Front Pharmacol"},{"issue":"1","key":"zoi230387r20","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1080\/00325481.2019.1685298","article-title":"Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study.","volume":"132","author":"Capano","year":"2020","journal-title":"Postgrad Med"},{"issue":"11","key":"zoi230387r21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0187795","article-title":"Associations between medical cannabis and prescription opioid use in chronic pain patients: a preliminary cohort study.","volume":"12","author":"Vigil","year":"2017","journal-title":"PLoS One"},{"issue":"3","key":"zoi230387r22","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1089\/can.2019.0039","article-title":"The impact of medical cannabis on intermittent and chronic opioid users with back pain: how cannabis diminished prescription opioid usage.","volume":"5","author":"Takakuwa","year":"2020","journal-title":"Cannabis Cannabinoid Res"},{"issue":"10","key":"zoi230387r23","doi-asserted-by":"publisher","first-page":"1668","DOI":"10.1001\/jamainternmed.2014.4005","article-title":"Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010.","volume":"174","author":"Bachhuber","year":"2014","journal-title":"JAMA Intern Med"},{"issue":"7","key":"zoi230387r24","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-047717","article-title":"Opioid-sparing effects of medical cannabis or cannabinoids for chronic pain: a systematic review and meta-analysis of randomised and observational studies.","volume":"11","author":"Noori","year":"2021","journal-title":"BMJ Open"},{"key":"zoi230387r2","unstructured":"Australian Government. Therapeutic Goods Administration. Medicinal cannabis Special Access Scheme Category B data. Accessed September 28, 2022. https:\/\/www.tga.gov.au\/medicinal-cannabis-special-access-scheme-category-b-data"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2804653\/arkell_2023_oi_230387_1683041682.84443.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T20:36:05Z","timestamp":1683664565000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2804653"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,9]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.12522","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,9]]}}}