Persistence of use of prescribed cannabinoid medicines in Manitoba, Canada: a population‐based cohort study

• Published in: Addiction (Abingdon, England) England), 2019-10, Vol.114 (10), p.1791-1799
• Main Authors: Alkabbani, Wajd, Marrie, Ruth Ann, Bugden, Shawn, Alessi‐Severini, Silvia, Bolton, James M., Daeninck, Paul, Leong, Christine
• Format: Article
• Language: English
• Subjects: Cancer; cannabinoid; Cannabinoids; Cannabis‐based pharmaceuticals; Cohort analysis; Demographics; Demography; Discontinued; Drug addiction; drug utilization; Economic status; Epidemiology; Fibromyalgia; Health behavior; Health policy; marinol; Medical diagnosis; Medical marijuana; nabilone; Osteoarthritis; Pain management; persistence; pharmaceutical cannabinoid; pharmaco‐epidemiology; Population-based studies; Prescription drugs; Sativex; Substance abuse; Substance use
• ISSN: 0965-2140; 1360-0443
• DOI: 10.1111/add.14719

Background and aims To estimate prevalence of continuous use (persistence) of prescribed cannabinoid medications for up to 1 year from initial prescription in Manitoba, Canada and predictors of duration of use. Design and setting A retrospective, population‐based, cohort study using administrative data from the Manitoba Population Research Data Repository located at the Manitoba Centre for Health Policy, Canada. Participants People without a record of a previous prescription who were prescribed a cannabinoid medication from 1 April 2004 to 1 April 2016 followed for 1 year from the date of first prescription. Measurements Continuous prescribed cannabinoid medication use was defined as use without a gap exceeding 60 days between prescriptions. The primary outcome was prevalence of continuous prescribed cannabinoid medication use for up to 1 year. A secondary outcome was duration of continuous use. Predictors were socio‐demographic characteristics, medical diagnoses and type of cannabinoid medication. Findings Among 5452 new users, 18.1% [95% confidence interval (CI) = 17.08–19.12] were still using cannabinoids at 1 year. Median duration of use was 31 days [interquartile range (IQR) = 25–193]. This was highest for nabilone (33 days, IQR = 25–199) and lowest for nabiximols (20 days, IQR = 7–30). Use was longest among 19–45‐ and 46–64‐year‐old users and those with the highest socio‐economic status. Fibromyalgia [hazard ratio (HR) = 0.89, 95% CI = 0.84–0.95], osteoarthritis (HR = 0.91, 95% CI = 0.82–0.97) and substance use disorder (HR = 0.85, 95% CI = 0.76–0.94) diagnoses were associated with longer use (HR for discontinuation—HR