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  • Canadian clinical practice guidelines for the use of plant-based cannabis and cannabinoid-based products in the management of chronic non-cancer pain and co-occurring conditions: protocol for a systematic literature review

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Medical management
Protocol
Canadian clinical practice guidelines for the use of plant-based cannabis and cannabinoid-based products in the management of chronic non-cancer pain and co-occurring conditions: protocol for a systematic literature review
  1. Patrick Wright1,
  2. Zach Walsh2,
  3. Shari Margolese3,
  4. Tatiana Sanchez2,
  5. Stephanie Arlt4,
  6. Lynne Belle-Isle1,
  7. Michelle St.Pierre2,
  8. Alan Bell5,
  9. Paul Daeninck6,
  10. Marilou Gagnon7,
  11. Gary Lacasse1,
  12. Caroline MacCallum8,
  13. Enrico Mandarino9,10,
  14. Janet Yale11,
  15. James O'Hara12,
  16. Cecilia Costiniuk13
  1. 1Canadian AIDS Society, Ottawa, Ontario, Canada
  2. 2Department of Psychology, University of British Columbia, Kelowna, British Columbia, Canada
  3. 3Canadian HIV Trials Network Community Advisory Board, Vancouver, British Columbia, Canada
  4. 4Canadian Institute for Substance Use Research,University of Victoria, Victoria, British Columbia, Canada
  5. 5Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
  6. 6Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
  7. 7Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
  8. 8Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  9. 9Community Advisory, Canadian Institutes of Health Research Canadian HIV Trials Network, Vancouver, British Columbia, Canada
  10. 10MJardin Canada, Toronto, Ontario, Canada
  11. 11Arthritis Society of Canada, Toronto, Ontario, Canada
  12. 12Canadians for Fair Access to Medical Marijuana, Toronto, Ontario, Canada
  13. 13Chronic Viral Illness Service, McGill University, Montreal, Quebec, Canada
  1. Correspondence to Mr Gary Lacasse; gary.lacasse{at}cdnaids.ca

Abstract

Introduction Chronic pain and co-occurring disorders, such as sleep disorders, anxiety, depression, post-traumatic stress disorder and substance use disorders, are among the most common conditions for which cannabis and cannabinoid-based products derived from the cannabis plant (CBP) are used for therapeutic purposes. However, healthcare providers report that they lack sufficient information on the risks, benefits and appropriate use of cannabis and CBP derived from the cannabis plant for therapeutic purposes.

Methods and analysis We will conduct a systematic review of studies investigating the use of cannabis and CBP derived from the cannabis plant for the treatment of chronic pain and co-occurring conditions. Randomised controlled trials, meta-analyses and observational studies will be prioritised. We will exclude reviews of cannabinoid mechanisms of actions, commentary articles and narrative reviews. The primary outcome of interest will be efficacy in relieving chronic pain. Secondary outcomes will be efficacy in ameliorating conditions such as sleep disorders, anxiety, depression, post-traumatic stress disorder and substance use disorders. We will search electronic bibliographic databases including Academic Search Complete, Cochrane Database of Systematic Reviews, Evidence based Medicine Reviewes, OVID Medline, PsychINFO, PubMed, CINAHL and Web of Science. Two reviewers will conduct screening and data collection independently. Study level of bias will be assessed using the Cochrane Risk of Bias Assessment Tool for randomised controlled trials and non-randomised studies. Narrative analysis will be utilised to interpret the data.

Ethics and dissemination The results of this systematic review will inform guideline development for the use of cannabis and CBP derived from the cannabis plant in the management of chronic pain and co-occurring conditions. Areas requiring further study will also be highlighted.

PROSPERO registration number CRD42020135886.

  • anxiety disorders
  • depression & mood disorders
  • sleep medicine
  • therapeutics
  • substance misuse
  • pain management
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-036114

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    Footnotes

    • Twitter @ms_st_pierre

    • Contributors PW and LB-I drafted the protocol. All authors, including MSP, AB, PD, MG, CM, EM, JY and JOH, had input into the protocol design and critically reviewed and revised the manuscript. TS and SA devised the search strategy, performed data extraction and data interpretation. PW and CC prepared the manuscript. The Data Synthesis Team (CC, ZW, SM, GL) was consulted for interpretation of the results. All authors conceived and designed the review, and read and approved the final manuscript. PW and CC are the guarantors of the review.

    • Funding Canadian Institutes for Health Research; Arthritis Society of Canada; Canopy Growth CorporationCC is supported by a Fonds de recherche du Québec-Santé Junior one career award.Neither the funders nor authors’affiliated institutions played any role in the development of the protocol.

    • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.