Cannabis use disorder (CUD) refers to continued cannabis use despite clinically significant impairment or distress. Symptoms include withdrawal, tolerance and cravings, hazardous use and social or interpersonal problems related to use. An estimated 22% of people who use cannabis will develop CUD, with higher risk among young people who use cannabis regularly (e.g., daily). Prevalence of CUD is increasing and globally more people are presenting to treatment services for support with cannabis use. There is currently no approved pharmacological treatment for CUD. Psychosocial interventions (e.g., cognitive behavioural therapy, motivational enhancement therapy) are recommended, but findings regarding efficacy are mixed. Recent systematic reviews of interventions for CUD have highlighted substantial variability in outcome domains (i.e., what is measured) and outcome measurement (i.e., how it is measured) across trials. This outcome heterogeneity reduces certainty in review findings and impedes quantitative synthesis in meta-analyses, ultimately delaying the identification of effective and safe treatments for CUD. The overarching aim of this project is to establish a core outcome set (COS) for CUD.
ContributorsDr Chloe Burke (University of Bath - Principal Investigator); Professor Tom Freeman (University of Bath); Professor Marta Di Forti (King's College London); Professor Nicholas Lintzeris (University of Sydney); Dr Lindsey Hines (University of Bath); Dr Rachel Lees Thorne (University of Bath)
Disease Category: Tobacco, drugs, & alcohol dependence
Disease Name: Cannabis use disorder/problematic cannabis use
Age Range: 16 - 120
Sex: Either
Nature of Intervention: Any
- Charities
- Clinical experts
- Consumers (caregivers)
- Consumers (patients)
- Epidemiologists
- Governmental agencies
- Journal editors
- Methodologists
- Patient/ support group representatives
- Policy makers
- Researchers
- Service commissioners
- Service providers
- Service users
- Statisticians
- COS for clinical trials or clinical research
- Consensus meeting
- Delphi process
- Literature review
- Semi structured discussion
- Survey
- Systematic review
The project will follow best practice guidelines for COS development as defined by the COMET framework, with dissemination and reporting aligned with the COS-STAR reporting guideline. Work Package 1 (WP1) will comprise a systematic review of outcome domains and measures used in trials of treatment for CUD. WP2 will comprise a qualitative exploration with relevant stakeholders to identify outcomes of importance to those with lived and professional experience of CUD. Findings from WP1+2 will be used to generate a longlist of outcomes for consideration. A Lived Experience Advisory Panel (LEAP) will translate the outcome longlist into lay language, and a multidisciplinary stakeholder meeting (e.g., CUD trialists, LEAP members, clinicians, evidence synthesis researchers) will shortlist and organise outcomes under broad headings (e.g., extent of cannabis use, quality of life). Each shortlisted outcome domain will be supplemented with information on available measures and psychometric evaluation (e.g., validity, reliability). The refined outcome list will be subject to a multi-round Delphi survey involving patients, clinicians, researchers, and policymakers, followed by a final consensus meeting. Findings will be disseminated through the COMET Initiative, peer-reviewed publications, conference presentations, and targeted engagement with relevant agencies including professional societies, research funders, journal editors, and clinical networks to encourage uptake into future research.