Medical cannabis versus standard pain management in patients with fibromyalgia

Abstract

Standard pain management (SPM) has been the only choice of treatment available for patients diagnosed with Fibromyalgia Syndrome (FS). Nowadays, the foundation of Medical Cannabis Therapy (MCT) has brought about an innovative approach to therapeutic aspect of FM. Optimizing pain treatment for each patient can be obtained after multiple trials, however evidence suggests that chronic disease are controlled with combined medication therapy rather than individual drug treatment approach (Claws, 2014 & Iliades, 2020). Although the overall effects of MCT remains a primary concern to several entities, many healthcare professionals and researchers are keen to learn and evaluate the long term outcomes of MCT. This dissertation has utilised an evidence based approach to define and compare MCT as an effective SPM in view of this emerging concern. Therefore, the Population, Intervention, Comparison, Outcome (PICO) framework was used to formulate the following research question; Is Medical Cannabis more effective than standard pain management approaches to reduce chronic pain and controlling symptoms in adult patients diagnosed with Fibromyalgia Syndrome? The retrieval of articles was carried out by accessing different databases including; PubMed, Google Scholar, BioMed Central and the University of Malta (UOM) HyDi portal, where seven relevant research studies were retrieved for this investigation. The articles consisted of a Randomised Clinical trial (RCTs), a systematic meta-analysis review and five cohort studies. During the search different keywords were used in order to generate significant articles. Moreover, an eligible criteria was established to make sure that the right articles were included. Those which explored the effectiveness of SPM to MCT in FM patients, whilst those studies which compared MCT to a placebo were also excluded. Studies which discussed other forms of alternative treatments rather than those selected were excluded. The retrieved articles were then appraised using various appraisal tools; the AMSTAR tool was utilised to critically appraise the systematic and meta-analysis review, whilst the CASP tool was utilised for the RCTs and Cohort studies. The outcomes obtained diverse results, favouring both MCT and SPM related to various aspects of FS. Thus, a well-founded conclusion could not be drawn to determine which treatment is more effective to treat FS. It was evident however, that due to incongruities results obtained, further investigation will be required in order to obtain a more conclusive answer for this enquiry. Results obtained showed that certain participants’ attained positive outcomes when MCT was introduced thus, their quality of life (QOL) significantly improved as FM symptoms decreased. Therefore, extensive knowledge and preparation should be accessible to healthcare professionals working with FM patients as to acquire further feedback while gathering stronger evidence with regards to this concern. Furthermore, a set of recommendations for the management and clinical practice of FM patients was proposed. In conclusion, patients suffering from such a chronic condition as FM, would benefit more if these findings and recommendations would be used in the local healthcare setting to inform healthcare professionals.