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Abstract
BACKGROUND AND AIMS:
To estimate prevalence of continuous use (persistence) of prescribed cannabinoid medications for up to one 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 April 1st , 2004 to April 1st , 2016 followed for one 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 one year. A secondary outcome was duration of continuous use. Predictors were sociodemographic characteristics, medical diagnoses and type of cannabinoid medication.
FINDINGS:
Among 5,452 new users, 18.1% (95% Confidence Interval [CI]= 17.08-19.12) were still using cannabinoidsat one 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 years old users and those with the highest socioeconomic 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<1 less discontinuation and longer use). A diagnosis of cancer was associated with shorter use (HR= 2.73, 95% CI= 2.02-3.67).
CONCLUSIONS:
In Manitoba, Canada approximately 18% of people prescribed cannabinoid medication continue using for at least one year. Duration of use varies with type of cannabinoid medication, age, socioeconomic status and diagnosis.
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