Cannabidiol Prescription Requests in NZ: Describing Patients and Indications Seen in a New Zealand Cannabis Clinic

Background: In 2017, revision of the Misuse of Drugs Act in New Zealand (NZ) allowed all medical practitioners to prescribe cannabidiol (CBD), a non-euphoriant constituent of cannabis. More information is needed on its therapeutic potential. This is an audit of all patients prescribed CBD from a single private clinic (Cannabis Care, Henderson, New Zealand) from 7 th December 2017 to 3 rd June 2020. We describe the patient population seeking CBD prescriptions in routine care in NZ, indications for use and quality of life (QOL) indices. Methods: Patient records were audited by the primary clinician, who had assessed indication for use and QOL indices (EuroQol-5D-5L and EQ-VAS). Indications were coded into four categories: non-cancer pain, emotional distress, neurological symptoms and cancer symptoms. Change in QOL and perceived patient efficacy was described where available. SAS version 9.4 was used. Data descriptions are by mean and standard deviation (SD). Categorical variables were described by counts and proportions expressed as percentages. Paired t-tests were used to compare V1 and V2 VAS scores. Results: Of 1264 patient records reviewed the mean age was 51 years (SD 20.6), with 55.5% female. Non-cancer pain was the primary indication for use (49.4%). The mean EQ-VAS score at first visit in patients over 16 years (n=924) was 50 (SD 22.3) and 65 (n=384, SD 21.1) at follow up. The mean difference in VAS score in returning patients (n=332) was -11.1 (95% CI -13.2 to -9.0, p<.0001), indicating a positive change in health rating. Conclusions: In NZ a range of patients are seeking CBD prescriptions, primarily for pain, with a sub-group reporting improved health following use. Further research into the clinical application of these products, especially dosage, precise indications and associated adverse events, is needed.