Abstract
Background: The Releaf AppTM mobile software application (app) data was used to measure self-reported effectiveness and side effects of medical cannabis used under naturalistic conditions.Methods: Between 5/03/2016 and 12/16/2017, 2,830 Releaf AppTM users completed 13,638 individual sessions self-administering medical cannabis and indicated their primary health symptom severity rating on an 11-point (0–10) visual analog scale in real-time prior to and following cannabis consumption, along with experienced side effects.Results: Releaf AppTM responders used cannabis to treat myriad health symptoms, the most frequent relating to pain, anxiety, and depressive conditions. Significant symptom severity reductions were reported for all the symptom categories, with mean reductions between 2.8 and 4.6 points (ds ranged from 1.29–2.39, ps < 0.001). On average, higher pre-dosing symptom levels were associated with greater reported symptom relief, and users treating anxiety or depression-related symptoms reported significantly more relief (ps < 0.001) than users with pain symptoms. Of the 42 possible side effects, users were more likely to indicate and showed a stronger correlation between symptom relief and experiences of positive (94% of sessions) or a context-specific side effects (76%), whereas negative side effects (60%) were associated with lessened, yet still significant symptom relief and were more common among patients treating a depressive symptom relative to patients treating anxiety and pain-related conditions.Conclusion: Patient-managed cannabis use is associated with clinically significant improvements in self-reported symptom relief for treating a wide range of health conditions, along with frequent positive and negative side effects.
Highlights
Medicinal cannabis use is expanding rapidly in the United States, with thousands of new users daily, older patients and people with significant health concerns, treating many different symptoms (Centers for Disease Control and Prevention, 2016; Han et al, 2016)
We used the Releaf AppTM repository of over 2,830 patients and 13,368 individual cannabis administration sessions to examine two research questions: How does cannabis used under naturalistic conditions affect user-experienced symptom relief and side effects? Does the magnitude of experienced symptom relief and the prevalence of side effects vary across symptom categories? The results have clinical relevance for understanding how patient-managed medical cannabis therapies may correspond to changes in symptom intensity and potential side effects among people using cannabis for treating distinct health conditions (Hill and Weiss, 2016; Rubin, 2017)
Using the adjusted symptom relief measure, all but users with convulsions, dizziness, excessive appetite, or tremors experienced a net improvement in their symptom severity levels
Summary
Medicinal cannabis use is expanding rapidly in the United States, with thousands of new users daily, older patients and people with significant health concerns, treating many different symptoms (Centers for Disease Control and Prevention, 2016; Han et al, 2016). Since its release in 2016, the commercially developed Releaf AppTM application (app; Releaf App, 2018) has been the only publically available, incentive-free patient educational software program designed for recording how individual cannabis usage sessions may correspond to immediate changes in primary symptom intensity levels and experienced side effects. This electronic assessment tool enables patients to monitor and manage their cannabis consumption decisions under naturalistic conditions while avoiding the limitations of retrospective survey collection methods (e.g., memory bias, social desirability effects). Of the 42 possible side effects, users were more likely to indicate and showed a stronger correlation between symptom relief and experiences of positive (94% of sessions) or a context-specific side effects (76%), whereas negative side effects (60%) were associated with lessened, yet still significant symptom relief and were more common among patients treating a depressive symptom relative to patients treating anxiety and pain-related conditions
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