Around 1 in 3 adults lives with at least one long-term health condition. Chronic pain alone is the leading cause of disability worldwide. These conditions often affect much more than physical health. They can also have a significant impact on mental wellbeing, daily activities, relationships, and work.
When considering any treatment, it is important to ask whether it may affect a patient’s overall quality of life. A recent systematic review and meta-analysis, published in the journal Quality of Life Research, looked at the health-related quality of life in those prescribed medical cannabis across a wide range of chronic conditions.
What is Health-Related Quality of Life?
Health-related quality of life (HRQoL) is an important patient-reported outcome (PRO) for determining the impact of chronic health conditions and the potential benefits of treatment options. Patient-reported outcome measures (PROMs) are questionnaires completed directly by patients in relation to their health condition and the effects of therapies. They are often repeated at regular intervals to allow comparisons between treatment groups, and within groups and individuals over time.
HRQoL is a concept that measures how an individual’s health status affects their physical, mental, and social well-being. The most widely used HRQoL measure is the EQ-5D-5L, which assesses five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
Medical Cannabis and HRQoL
Health-related quality of life (often shortened to HRQoL) is a way of measuring how a health condition affects a person’s overall wellbeing. It looks at several areas of daily life, including physical health, emotional wellbeing, the ability to carry out everyday activities, and social connections.
HRQoL is measured using patient-reported outcome measures, or PROMs. These are questionnaires that patients complete themselves about how they feel and how their condition affects their life. One of the most widely used is the EQ-5D-5L. This questionnaire looks at five areas: mobility, self-care, usual activities, pain or discomfort, and anxiety or depression.
Because HRQoL captures the broader impact of a condition on a person’s life, it is considered an important measure in research into chronic health conditions and their management.
What is a PROM? A patient-reported outcome measure (PROM) is a standardised questionnaire. Patients fill it in themselves without input from their doctor. PROMs allow researchers to track changes in a patient’s health and wellbeing over time.
What Did This Review Examine?
The review, conducted by researchers at the University of Sydney, analysed studies published between January 2015 and April 2025. It looked at all available evidence assessing patients’ HRQoL before and after medical cannabis treatment.
The researchers set out to answer three questions. First, how do studies of medical cannabis define and measure HRQoL, and what questionnaires are used? Second, how well do these studies report their HRQoL findings? Third, are there any changes in HRQoL over the short term (2 weeks to 3 months), medium term (3 to 12 months), and long term (12 months or more)?
The review included randomised controlled trials (RCTs), cohort studies, and case series. All studies involved adults with a diagnosed health condition who had been prescribed medical cannabis for symptom management. Only studies using validated questionnaires to measure HRQoL at baseline and at follow-up were included.
Which Chronic Conditions Were Included?
The review included 64 studies involving a total of 43,847 patients. Most were observational cohort studies. The conditions studied covered a broad range, including chronic pain, multiple sclerosis, cancer, anxiety disorders, inflammatory bowel disease (including Crohn’s disease and ulcerative colitis), epilepsy, fibromyalgia, arthritis, sleep disorders, post-traumatic stress disorder, and headache disorders, among others.
A third of the included studies (22 out of 64) were conducted in the United Kingdom, with 19 of these collecting data through the UK Medical Cannabis Registry.
How Was Quality of Life Measured in These Studies?
The review found that most studies (81%) used generic HRQoL questionnaires. The EQ-5D-5L was the most commonly used, appearing in nearly half (48%) of the studies. The RAND SF-36, another widely used generic questionnaire, was used in around a fifth (22%) of studies. A smaller number of studies (19%) used condition-specific questionnaires, such as those designed for multiple sclerosis or epilepsy.
However, the review also found that only 5 out of 64 studies (8%) provided a clear definition of what they meant by HRQoL. Around a third of studies did not explain why they chose to measure HRQoL at all. The researchers noted that this lack of clarity could affect how findings are interpreted and compared across studies.
What Did the Review Find About Changes in Quality of Life?
Findings from randomised controlled trials
In RCTs comparing medical cannabis with a placebo, the review reported a small overall improvement in HRQoL over the short term (2 weeks to 3 months). None of the trials included in the analysis were found to have a high risk of bias in measuring outcomes as determined by the authors of the review.
However, HRQoL improvements varied depending on the condition being treated. The RCTs that reported the most notable changes involved patients with inflammatory bowel disease or fibromyalgia. By contrast, no meaningful changes were observed in RCTs involving patients with cancer, HIV-associated neuropathic pain, or hypertension.
Findings from observational studies
In observational studies, the review reported changes in HRQoL across all follow-up periods. These were as follows:
- Short term (up to 3 months): Moderate improvements were reported. Around 79% of short-term observational studies found significant improvements in HRQoL.
- Medium term (3 to 9 months): Moderate to large improvements were reported, with 95% of studies finding significant changes.
- Long term (12 to 24 months): Moderate improvements appeared to be maintained. All studies covering this period reported significant improvements from baseline.
The largest changes were reported in studies involving patients with anxiety, post-traumatic stress disorder, and chronic pain. Results were more mixed for patients with multiple sclerosis, where some studies reported improvements and others did not.
What are the Important Limitations of This Research?
As with all research, there are important limitations that should be considered when interpreting these findings.
The majority of the included studies were observational. In these observational studies, there was no placebo comparison, which means it is not possible to know whether any reported changes were due to the treatment, a placebo effect, or natural changes over time.
Observational studies may also be affected by attrition bias. This means that patients who continue in a study over time may be those who are benefiting from treatment, while those who are not benefiting or who experience side effects may drop out. The review noted that many observational studies did not report any attempts to address this type of bias.
The review also found that different studies used different questionnaires to measure HRQoL, and that results could vary depending on which questionnaire was used — even when studying the same group of patients. This makes it difficult to compare findings directly across studies.
Furthermore, as only a small number of the included studies provided a clear definition of HRQoL, the review authors emphasised the need for future research to be more explicit about how HRQoL is defined, measured, and reported.
What Does This Mean for Patients?
This review provides an overview of the current evidence on how HRQoL may change in patients prescribed medical cannabis across a range of chronic conditions. Overall, the findings suggest that some patients may experience improvements in quality of life, but these varied between conditions and studies.
It is important to note that medical cannabis is a prescription-only medicine in the UK. It is typically considered only after other licensed treatments have been tried and found to be inadequate. Any decision about treatment should be made in consultation with a specialist doctor who can assess individual circumstances and discuss the potential benefits and risks.
If you are living with a chronic health condition and would like to learn more about whether you might be suitable for a specialist consultation, you can complete our eligibility assessment on the Curaleaf Clinic website.
What is the UK Medical Cannabis Registry?
Medical cannabis has been legally available in the United Kingdom since November 2018. Specialist doctors can prescribe cannabis-based medicines to eligible patients with a range of conditions where other treatments have not provided adequate relief.
At Curaleaf Clinic, patients who are prescribed medical cannabis may choose to enrol in the UK Medical Cannabis Registry. This registry supports the ongoing collection of real-world observational data about the safety and outcomes of medical cannabis treatment in the UK. The data collected helps contribute to the growing body of evidence in this area.
Important: This article is for informational and educational purposes only. It does not constitute medical advice. Medical cannabis is a prescription-only medicine and is not suitable for everyone. Always consult a qualified healthcare professional before making any decisions about your treatment.
