Cannabidiol prescription in clinical practice: an audit on the first 400 patients in New Zealand

Graham Gulbransen; William Xu; Bruce Arroll

doi:10.3399/bjgpopen20X101010

Cannabidiol prescription in clinical practice: an audit on the first 400 patients in New Zealand

BJGP Open. 2020 May 1;4(1):bjgpopen20X101010. doi: 10.3399/bjgpopen20X101010. Print 2020.

Authors

Graham Gulbransen¹, William Xu², Bruce Arroll³

Affiliations

¹ Private Practitioner, Cannabis Care NZ, West Care Specialist Centre, Auckland, New Zealand doctor@cannabiscare.nz.
² Medical Student, Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
³ Professor and Head of Department, Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

Abstract

Background: Cannabidiol (CBD) is the non-euphoriant component of cannabis. In 2017, the New Zealand Misuse of Drugs Regulations (1977) were amended, allowing doctors to prescribe CBD. Therapeutic benefit and tolerability of CBD remains unclear.

Aim: To review the changes in self-reported quality of life measurements, drug tolerability, and dose-dependent relationships in patients prescribed CBD oil for various conditions at a single institution.

Design & setting: An audit including all patients (n = 400) presenting to Cannabis Care, New Zealand, between 7 December 2017 and 7 December 2018 seeking CBD prescriptions METHOD: Indications for CBD use were recorded at baseline. Outcomes included EuroQol quality of life measures at baseline and after 3 weeks of use, patient-reported satisfaction, incidence of side effects, and patient-titrated dosage levels of CBD.

Results: Four hundred patients were assessed for CBD and 397 received a prescription. Follow-up was completed on 253 patients (63.3%). Patients reported a mean increase of 13.6 points (P<0.001) on the EQ-VAS scale describing overall quality of health. Patients with non-cancer pain and mental-health symptoms achieved improvements to patient-reported pain and depression and anxiety symptoms (P<0.05). There were no major adverse effects. Positive side effects included improved sleep and appetite. No associations were found between CBD dose and patient-reported benefit.

Conclusion: There may be analgesic and anxiolytic benefits of CBD in patients with non-cancer chronic pain and mental health conditions such as anxiety. CBD is well tolerated, making it safe to trial for non-cancer chronic pain, mental health, neurological, and cancer symptoms.

Keywords: analgesics; anti-anxiety agents; cannabidiol; cannabis; chronic pain; community care; depression; mental health; patient reported outcome measures; prescribing; therapy in mental health.