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CTNPT 037: Smartphone assessment of medicinal and non-medicinal cannabis use

Disentangling medicinal and non-medicinal cannabis use among people living with HIV: Feasibility of a smartphone-based assessment

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About the study (objectives)

This pilot study aims to use smartphone-based surveys to assess the risks and benefits associated with medicinal and non-medicinal cannabis use among people living with HIV (PLWHIV). Specifically, the investigators aim to determine 1) the feasibility of using smartphone-based surveys to assess cannabis use and associated patient-reported outcomes at the time they occur; 2) if this approach can be used to examine differences in patient-reported outcomes between medicinal versus non-medicinal cannabis use episodes.

About the disease/condition (background/context)

Between 35-47% of PLWHIV report that they currently use cannabis, with around half of these people saying they use cannabis for medicinal reasons. To date, scientific studies have yet to determine exactly how medicinally beneficial or harmful cannabis may be for PLWHIV. Furthermore, the retrospective, self-reported nature of these studies may blur the line between when cannabis use is medicinal or non-medicinal.

Ecological Momentary Assessment (EMA) is a tool that allows researchers to assess someone’s behaviour almost in real time. In CTNPT 037, EMA will involve smartphone-based surveys that participants will complete whenever they use cannabis, in order to examine the effects of both medicinal and non-medicinal cannabis use within the same individual across different occasions. The results of this study could have implications on policy around medicinal cannabis use and also help contribute to the design of a mobile health intervention app for PLWHIV who may be at risk of cannabis harms.

Study approach (methodology)

The study will recruit 30 participants, who will download an app to their smartphone that contains user-friendly surveys to complete over a 14-day period. The surveys include: a pre-cannabis survey to complete each time they are about to use cannabis to document why they are going to use it (i.e., medicinal or non-medicinal reasons); a post-cannabis survey to complete after using cannabis to explain how they used it and the resulting benefits and harms; and daily morning surveys to input information on cannabis use and motives from the previous day. Participants will receive prompts to their phone to remind them to complete each survey.

Participants will also attend a follow-up visit at the end of the 14-day period so they can provide feedback on the user experience of the study, such as the design, clarity, acceptability, and ease of use of the surveys. This information will help improve future EMA survey studies. The participants will also be asked to complete an interview assessing their use of cannabis and other substances over the study period, which will be compared to the data collected through their EMA assessments.

Eligibility criteria

Inclusion criteria:

  • At least 19 years old
  • Diagnosed with HIV over a year ago
  • Take antiretroviral medication
  • Daily cannabis use
  • Use cannabis for both medicinal and recreational reasons
  • Own a compatible smartphone with internet access

Exclusion criteria:

  • Treatment for cannabis use disorder, alcohol use disorder, or any other substance use disorder
  • Actively trying to quit or cut down on cannabis use
  • Drink heavily on three or more days per week, on average
  • Use drugs (aside from cannabis, alcohol, or nicotine) two or more times a week, on average
  • Diagnosed with a severe mental illness
  • Medical instability that would interfere with participation (e.g. frequent hospitalization)
  • Pregnant or breastfeeding
  • Unable to travel to the Centre for Addiction and Mental Health for baseline/follow-up visits
  • Unable to complete the assessments in English

Participating sites

The Centre for Addiction and Mental Health
Toronto, ON

Principal Investigator:

Dr. Jeffrey Wardell
Institute for Mental Health Policy Research,
Centre for Addiction and Mental Health,
33 Russell St., Toronto, Ontario,
M5S 2S1

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