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This study applied longitudinal k\u2010means clustering to pain\u2010severity trajectories in patients treated with CBMPs for chronic pain to distinguish patterns of response and identify the baseline characteristics predicting them over 24 months. A cohort study was undertaken of UK Medical Cannabis Registry participants whose primary indication was chronic pain. Pain, health\u2010related quality of life, anxiety, and sleep were assessed with patient\u2010reported outcome measures, including the Brief Pain Inventory Short Form (BPI\u2010SF), EuroQol 5\u2010Dimension 5\u2010Level (EQ\u20105D\u20105L), Generalised Anxiety Disorder\u20107, and Single\u2010Item Sleep Quality Scale, at baseline up to 24 months. BPI\u2010SF pain\u2010severity trajectories were grouped by longitudinal k\u2010means clustering. The number of clusters was chosen using the gap statistic and predictors of cluster membership were examined by logistic regression. Of 3744 patients included, every outcome improved from baseline to 24 months, including BPI\u2010SF pain severity (d = 0.57), pain interference (d = 0.59), and the EQ\u20105D\u20105L index value (d = \u22120.76; all\n                    <jats:italic>P<\/jats:italic>\n                    &lt; \u00a0.001). More than half of patients achieved a minimal clinically important difference in each pain measure at 24 months. Five distinct trajectory clusters emerged. All ended below their baseline severity, but the magnitude and pattern of change varied markedly. Adverse events were reported by 14.37% (n = 538) of patients, predominantly mild or moderate. Baseline sleep quality, anxiety, and treatment indication were more strongly associated with response than product\u2010 or dose\u2010related factors.\n                  <\/jats:p>","DOI":"10.1002\/jcph.70313","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T10:33:46Z","timestamp":1792146826000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pain Severity Trajectories and Patient Profiles in Chronic Pain Patients Treated with Cannabis\u2010Based Medicinal Products: A k\u2010Means Clustering Analysis of the UK Medical Cannabis Registry"],"prefix":"10.1002","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5871-6501","authenticated-orcid":false,"given":"Simon","family":"Erridge","sequence":"first","affiliation":[{"name":"Medical Cannabis Research Group Department of Surgery and Cancer Imperial College London  London UK"},{"name":"Curaleaf Clinic Curaleaf International  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5910-9081","authenticated-orcid":false,"given":"Aritra","family":"Datta","sequence":"additional","affiliation":[{"name":"Medical Cannabis Research Group Department of Surgery and Cancer Imperial College London  London UK"},{"name":"Curaleaf Clinic Curaleaf International  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6776-198X","authenticated-orcid":false,"given":"Aditya","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Medical Cannabis Research Group Department of Surgery and Cancer Imperial College London  London UK"},{"name":"Curaleaf Clinic Curaleaf International  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9426-1655","authenticated-orcid":false,"given":"Dhruv","family":"Vasooja","sequence":"additional","affiliation":[{"name":"Medical Cannabis Research Group Department of Surgery and Cancer Imperial College London  London UK"},{"name":"Curaleaf Clinic Curaleaf International  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Coomber","sequence":"additional","affiliation":[{"name":"Curaleaf Clinic Curaleaf International  London UK"},{"name":"St. George's Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushil","family":"Beri","sequence":"additional","affiliation":[{"name":"Curaleaf Clinic Curaleaf International  London UK"},{"name":"Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaheen A.","family":"Khan","sequence":"additional","affiliation":[{"name":"Curaleaf Clinic Curaleaf International  London UK"},{"name":"Guy's and St. Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W.","family":"Weatherall","sequence":"additional","affiliation":[{"name":"Curaleaf Clinic Curaleaf International  London UK"},{"name":"Buckinghamshire Healthcare NHS Trust  Amersham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Platt","sequence":"additional","affiliation":[{"name":"Curaleaf Clinic Curaleaf International  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Rucker","sequence":"additional","affiliation":[{"name":"Curaleaf Clinic Curaleaf International  London UK"},{"name":"Department of Psychological Medicine King's College London London UK"},{"name":"South London and Maudsley NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro A. 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