Health-related quality of life in patients receiving medicinal cannabis: systematic review and meta-analysis of primary research findings 2015–2025

Summary & key facts

This paper reviewed studies from 2015 to 2025 that measured how medicinal cannabis affects people's health-related quality of life, which means how health problems affect daily life and wellbeing. The authors pooled results from 64 studies, including 12 trials where people were randomly assigned to treatment or control. Randomised trials found a small short-term benefit, while observational studies generally showed bigger improvements across short, medium, and long follow-up. Many studies did not clearly define what they meant by quality of life or explain why they measured it, so the findings are promising but have limits.

Key facts:

• The review combined 64 studies published between 2015 and 2025, including 12 trials where patients were randomly assigned to treatment or control.
• About 60% of studies explained why they measured health-related quality of life, but only about 8% gave a definition of what they meant by it.
• Most studies used general quality of life questionnaires that work across many conditions, and the EQ-5D-5L was the single most common measure used.
• Across the randomised trials, there was a small short-term improvement in quality of life following medicinal cannabis treatment.
• Observational studies reported larger improvements, with effect sizes roughly in the moderate to large range across short, medium, and long follow-up periods.
• The amount of improvement varied between different health conditions and even between studies of the same condition.
• The quality of the evidence varied. Some trials had low risk of bias while others raised some concerns, so the results should be interpreted with caution.
• The authors recommend that future studies clearly define what they mean by quality of life and explain why they are measuring it so results can be compared and trusted more easily.

Abstract

PURPOSE: The global burden of chronic health conditions is significant. Medicinal cannabis (MC) is a legalised treatment option for patients with chronic health conditions in some countries. Health-related quality of life (HRQL) is an important patient-reported outcome across all chronic health conditions. We aimed to determine how studies of MC therapy justify, measure, and report HRQL, and assess the current evidence for HRQL following MC treatment. METHODS: Systematic review searching AMED, Medline, Web of Science, Scopus, Embase, Cinahl, and PsycINFO from Jan 2015 to Apr 2025. Studies using validated HRQL measures pre-, and post-MC treatment for any chronic health condition were included. Screening and data extraction were performed independently by two reviewers. Completeness of HRQL reporting was evaluated. Meta-analyses for short-term (2-weeks to 3-months), medium-term (> 3 to < 12-months), and long-term (≥ 12-months) HRQL outcomes were conducted, with Risk of Bias (RoB) assessed in randomised control trials (RCTs). RESULTS: Of 16,674 retrieved citations, 64 studies were retained for analysis:12 RCTs; 38 cohort studies; 13 case series; 1 non-randomised experimental study. Thirty-nine studies (61%) provided justification for assessing HRQL and five (8%) provided HRQL definitions. Studies used generic (n = 52, 81%) or condition-specific (n = 12, 19%) HRQL measures, with EQ-5D-5L most commonly used. Meta-analyses: RCTs showed small short-term HRQL improvements (Cohen's d = 0.30, p = 0.03), with some concerns or low RoB. For observational studies, HRQL improved in all follow-up periods (d = 0.43 to 0.74; all p < 0.001). HRQL improvement varied between, and within, different health conditions. CONCLUSION: This systematic review and meta-analyses of studies published between 2015 and 2025 found that few studies provided HRQL definitions, and a third of studies did not explain why they measured HRQL. To ensure appropriate measures are used for this important treatment outcome, future studies should define HRQL and justify the HRQL assessment in the context of research objectives. Overall, improvements in HRQL were observed across studies of patients using MC.

Topics

Cannabis and Cannabinoid Research Opioid Use Disorder Treatment Psychedelics and Drug Studies

Categories

Health Sciences Medicine Pharmacology

Tags

Alternative medicine Context (archaeology) Family medicine Gerontology Health related quality of life Health services research Intensive care medicine Medicine MEDLINE Primary care Public health Quality (philosophy) Quality of life (healthcare) Quality of Life Research Research design Systematic review

Substances

medical cannabis

Conditions & symptoms

Chronic Pain Chronic pain