Tags: cannabis; cannabidiol; CBD; THC; tetrahydrocannabinol; older adults; safety; effectiveness

 

Thumbnail: This study aims to provide a descriptive analysis of older adults who were early participants in Florida’s cannabis program. Treatment follow-ups throughout treatment provided information on a number of different demographic, medical and health indicators, but lacked enough detail to assess safety or efficacy of cannabis use among these older adults.

 

The problem: Cannabis use is increasing throughout the US, and the fastest growing user group is adults aged 50 years or older. However, patients in this older age group tend to be more medically complex than younger individuals, and we don’t know much about the characteristics and outcomes related to cannabis use in older individuals.

 

The study: This retrospective study analyzed data collected from patients enrolled in a medical cannabis program in Florida; including demographics, clinical history, medical conditions, substance use history, prescription history, and health status. The study also reviewed follow up treatment plans for any changes in medical complaints or changes in treatment since the initial visit.  Data was analyzed from initial and follow-up treatment plans submitted to the University of Florida College of Pharmacy; of 7548 total treatment plans submitted from Aug 2016 to July 2017, 4447 fit the age group of older adults, and were analyzed in this study.

 

Main Points:

• 45% of patients used cannabidiol (CBD)-only preparations, 33% used preparations that had both tetrahydrocannabinol (THC) and CBD, while 21.7% used both CBD-only and THC + CBD products

• The main complaints that warranted the prescription of cannabis were pain-related: musculoskeletal disorders and spasms accounted for 48.4% of prescriptions and 45.4% used it for chronic pain.

• Cancer was an indication for 15.5% of all patients

• On average, patients used roughly 2.5 other medications, in addition to cannabis: 23.8% of patients also used antidepressants, 23.5% used anxiolytics and benzodiazepines, 28.6% used opioids, and 27.9% also used cardiovascular agents.

• 27.5% of patients showed significant improvement (as reported by physician assessment) in their complaint; less than 3% reported worsening conditions

• Adherence to treatment plans appears to be low, as only 27.5% of patients recorded a second follow up visit.

• Some patients reported notable changes in medication regimens including stopped opioid medications, improved sleep quality, reduction of medications for sleep, and reduced use of anxiety medications

• The patient registry did not have enough details to thoroughly assess safety or efficacy of cannabis treatment

 

Conclusions: This study provides a descriptive analysis of older adults using cannabis. It summarizes the chief complaints leading to the prescription of medical cannabis and usage habits of patients. It indicates that improvements to registries are necessary to allow for the study of efficacy and safety of cannabis treatments.

 

Why this is a good study:

• This study analyzes a large number of patients, providing a good representation of older adults in the region who are prescribed medical cannabis

• This study provides a thorough evaluation of a number of important patient characteristics, and reports the frequency of all- regardless of significance

 

Why this isn’t a perfect study:

• This study cannot provide conclusions about racially mixed populations, as the majority of patients (87.5 %) were white

• The limitations of registry data means that this study cannot make any determination about the efficacy or safety of these cannabis treatments

• The limited timeframe studied, 1 year, may not have been long enough to determine all improvements/complications of treatment, or capture all follow-up visits

 

What this study adds:

• This study characterizes a growing, but understudied, population of patients who use medical cannabis

 

What it doesn’t:

• This study does not provide any determination for which types or compositions of cannabis products might be most beneficial

• While it reports the use of other medications in combination with cannabis, it does not draw any conclusions about the risks of adverse drug interactions between cannabis and these medications

 

Funder: This work was supported in part by direct state appropriation to the University of Florida College of Pharmacy to collect treatment plans for the purpose of conducting research on the safety and efficacy of cannabis

 

Author conflicts:  None