Abstract
Purpose Medical cannabis for patients with chronic noncancer pain (CNCP) has been the focus of numerous health care recommendations. We conducted a systematic review to identify and summarize the currently available evidence-based recommendations. Methods We searched MEDLINE, EMBASE, PsycINFO, the Cochrane database of systematic reviews, and websites for clinical guidelines and recommendations. We summarized the type of the publications, developers, approach of health care recommendation development, year and country of publication, and conditions that were addressed. We categorized the direction and strength of each recommendation. Results We identified 12 eligible publications. Publication years ranged from 2007 to 2019; four (33.3%) of them were published in 2018. Canada ranked first for the number of publications (n = 4, 33.3%). Most (n = 11, 92%) of the included recommendations were based on both a systematic review of the best evidence and expert consensus. All the included publications provided a recommendation supporting medical cannabis for CNCP in general and for the specific conditions of neuropathic pain, chronic pain in people living with Human Immunodeficiency Virus (HIV), and chronic abdominal pain, with detailed information sharing and comprehensive consideration of a patient's own values and preferences. Conclusion Clinicians can attend to the guidance currently offered, being aware that only weak recommendations are available for medical cannabis in patients with CNCP, as a third- or fourth-line therapy. Detailed discussions with patients regarding the benefits in reducing pain and potential adverse effects are required before its prescription.
Highlights
Medical cannabis for patients with chronic noncancer pain (CNCP) has been the focus of numerous health care recommendations
Medical use of cannabis has been the focus of numerous health care recommendations. ese statements are intended to optimize patient care and are informed by a systematic review of the evidence providing an assessment of the benefits and harms of alternative care options [9,10,11]
We aimed to search for and summarize all published health care recommendations, including those stated in clinical practice guidelines, to inform clinicians, patients, and policy-makers when considering the use of medical cannabis for CNCP
Summary
Medical cannabis for patients with chronic noncancer pain (CNCP) has been the focus of numerous health care recommendations. We conducted a systematic review to identify and summarize the currently available evidence-based recommendations. All the included publications provided a recommendation supporting medical cannabis for CNCP in general and for the specific conditions of neuropathic pain, chronic pain in people living with Human Immunodeficiency Virus (HIV), and chronic abdominal pain, with detailed information sharing and comprehensive consideration of a patient’s own values and preferences. Chronic noncancer pain (CNCP) is defined as any painful condition that persists for three or more months that is not associated with a diagnosis of cancer Such conditions include neuropathic pain, low back pain, osteoarthritis, rheumatoid arthritis, fibromyalgia, irritable bowel syndrome, and headache [6]. Recommendations are often developed in the context of clinical practice guidelines and play an important role in facilitating more consistent, effective, and efficient medical practice in order to improve health outcomes [12, 13]
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