[Patient-reported outcomes in chronic diseases under treatment with cannabis medicines : Analysis of the results of the Copeia survey]. / "Patient-reported outcomes" bei chronischen Erkrankungen unter Therapie mit Cannabisarzneimitteln : Analyse der Ergebnisse der Befragung von Copeia.

BACKGROUND: The survey of Copeia captured early 2022 patient-reported outcomes (PRO) in Germany under cannabis medicinal product (CAM) therapy, with particular attention to symptoms, symptom changes, indications, side effects, dosages, and cost bearers. GOAL: This study investigated the question of whether associations emerge from the results that could play a role in the indication and treatment monitoring of CAM in chronically ill patients. MATERIALS AND METHODS: A standardized questionnaire was administered online nationwide in dialogue form over a 15-week period to collect itemized symptoms and PRO. Recruitment was supported by pharmacies, prescribing physicians, and patient associations. Inclusion criteria included physician-prescribed CAM therapy. RESULTS AND DISCUSSION: Of 1582 participants, 1030 data sets (65%) could be completely analyzed. There was a heterogeneous patient population, whose common feature was disease chronicity. The frequency distribution of symptoms showed a homogeneous pattern for the respective indications, in which the most frequent six (pain 71%, sleep disturbance 64%, stress/tension 52%, inner restlessness 52%, depressive mood 44% and muscle tension 43%) seem to have a special significance. According to subjective assessment, quality of life improved significantly in 84% of all participating patients. CONCLUSION: A symptom matrix (SMX) composed of different symptoms seems to play a special role in CAM therapy to improve the quality of life of chronically ill patients, regardless of the underlying disease. The SMX could contribute to the identification of an indication and to targeted treatment monitoring.

[Dronabinol in geriatric pain and palliative care patients : A retrospective evaluation of statutory-health-insurance-covered outpatient medical treatment]. / Dronabinol bei geriatrischen Schmerz- und Palliativpatienten : Eine retrospektive Auswertung der ambulanten kassenärztlichen Therapie.

BACKGROUND: Geriatric patients often suffer from a long history of pain and have a limited life expectancy. Cannabinoid receptor agonists like dronabinol may be an effective, low-risk treatment option for geriatric patients with chronic pain. OBJECTIVES: The effectiveness and side effects of dronabinol therapy in geriatric patients are analyzed. The effects of the approval requirement are presented. METHODS: In our retrospective monocentric cohort study, the study population comprised all geriatric patients over the age of 80 years who were treated in our office since the cannabis law came into effect on 10 March 2017 until 17 July 2018 (evaluation date). Geriatric, nonpalliative pain patients (group A) and geriatric palliative patients (group B) were investigated. The basis of the evaluation was a questionnaire sheet that we use in our office with details of dosages, pain intensity, treatment effects and side effects from dronabinol therapy. RESULTS: By using dronabinol, 21 of the 40 geriatric patients (52.5%) achieved pain relief of more than 30%, 10% of the patients of more than 50%. On average, about four symptoms or side effects related to previous treatment were positively influenced. 26% of patients reported side effects. The rejection rates on the part of the health insurances were 38.7% (group A) and 10.3% (group B). CONCLUSIONS: This study is one of the few analyses of the use of Dronabinol in geriatric patients. We show that cannabis-based drugs (in this case dronabinol) are an effective, low-risk treatment option that should be considered early in therapy. Regarding the indication spectrum, further clinical studies and an approval-free test phase are necessary.

[High-dose dronabinol treatment vs. medicinal cannabis flowers]. / Hochdosisdronabinoltherapie vs. Medizinalcannabisblüten.

This article reports a case of pronounced, chronic lumboischialgia, which was not satisfactorily controlled by conventional analgesic treatment. The level of pain under high-dose dronabinol treatment with oral and inhalative administration as well as the way to reimburse the cost of medicinal cannabis flowers, the treatment success and criteria of the economic prescription procedure are presented.