Abstract
•Our study reveals diverse Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) dosing patterns among patients with medical conditions, drawn from longitudinal purchase data, providing insights into patient dosing.•Six trajectory groups illustrate varied THC and CBD dosing trends over time, reflecting nuanced patient behaviors and highlighting dynamic dosing trajectories.•Patients exhibit customized dosing preferences, with THC favored by patients with chronic pain and cancer and CBD preferred by those with epilepsy, indicating tailored dosing preferences.•Many patients exhibited fluctuating dosing behaviors, highlighting the necessity for personalized dosing strategies and emphasizing fluctuating dosing behaviors.•Our findings stress the need for standardized dosing guidelines and comprehensive patient education to ensure the tolerability of medical cannabis, calling for standardization.
Medical cannabis use is rising with limited high-quality clinical trial data to guide dosing. This study relies on real-world, longitudinal medical cannabis purchase data to provide information on Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) dosing trends for patients with qualifying medical conditions.
A retrospective study of purchases by 16,727 patients obtaining medical cannabis from dispensaries located in New York between 2016 and 2019, recorded in point-of-sale data. Group-based trajectory modeling was used to identify clusters of patients following similar progressions in dosing of THC and CBD over time. χ2 tests were performed to identify which patient characteristics and qualifying medical conditions were associated with membership in each trajectory group.
Six trajectory groups were identified that described different patterns in the THC and CBD doses that patients purchased over the whole time period. For THC, the majority of patients (62.6%) purchased a steady amount but at different levels: consistently low (4.1 mg) or moderate (7.4 mg). Three groups, representing 22.0% together, exhibited doses that either fluctuate or constantly increase over time (5–20 mg). A final group of patients (15.8%) exhibited constant decrease in dose from 11 to 5 mg. For CBD, the data show similar trajectories, but at the generally higher values (4–16 mg). Patients with chronic pain, neuropathy, and cancer were overrepresented in groups where higher doses of THC were purchased over time. Patients with epilepsy had a higher representation in groups with higher doses of CBD across time.
Results suggest heterogeneous dosing patterns and trajectories in the use of medical cannabis by patients with different medical conditions.