• Pharmacoepidemiologic characte...

Result: Pharmacoepidemiologic characterization of cannabis use and symptomatology in rheumatology using natural language processing of electronic health record clinic notes.

Title:
Pharmacoepidemiologic characterization of cannabis use and symptomatology in rheumatology using natural language processing of electronic health record clinic notes.
Authors:
Falasinnu T; Division of Immunology and Rheumatology, Stanford School of Medicine, CA, United States; Division of Pain Medicine, Stanford School of Medicine, CA, United States. Electronic address: tof@stanford.edu., Le N; Division of Immunology and Rheumatology, Stanford School of Medicine, CA, United States., Wang Y; Division of Pain Medicine, Stanford School of Medicine, CA, United States., Alagappan A; Division of Immunology and Rheumatology, Stanford School of Medicine, CA, United States., Walker A; Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, United States., Park T; Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, United States., Leung J; Rollins School of Public Health, Emory University, Atlanta, GA, United States., Chaichian Y; Division of Immunology and Rheumatology, Stanford School of Medicine, CA, United States., Weisman M; Division of Immunology and Rheumatology, Stanford School of Medicine, CA, United States., Kenney M; Department of Anesthesiology, Duke University School of Medicine, Durham, NC, United States., Irani A; Mayo Clinic, Jacksonville, FL, United States., Bozkurt S; Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, United States.
Source:
The journal of pain [J Pain] 2026 Feb; Vol. 39, pp. 105633. Date of Electronic Publication: 2025 Dec 05.
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: Churchill Livingstone Country of Publication: United States NLM ID: 100898657 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-8447 (Electronic) Linking ISSN: 15265900 NLM ISO Abbreviation: J Pain Subsets: MEDLINE
Imprint Name(s):
Original Publication: Philadelphia, PA : Churchill Livingstone, c2000-
MeSH Terms:
Natural Language Processing* , Electronic Health Records*/statistics & numerical data , Rheumatic Diseases*/drug therapy , Rheumatic Diseases*/epidemiology , Pharmacoepidemiology* , Marijuana Use*/epidemiology , Medical Marijuana*/therapeutic use, Humans ; Male ; Female ; Middle Aged ; Adult ; Aged ; Young Adult ; Rheumatology
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Grant Information:
K01 AR079039 United States AR NIAMS NIH HHS
Contributed Indexing:
Keywords: Autoimmune Rheumatic Diseases; Cannabis; Natural Language Processing; Pain Management
Substance Nomenclature:
0 (Medical Marijuana)
Entry Date(s):
Date Created: 20251207 Date Completed: 20260122 Latest Revision: 20260123
Update Code:
20260130
PubMed Central ID:
PMC12725458
DOI:
10.1016/j.jpain.2025.105633
PMID:
41354127
Database:
MEDLINE

Further Information

Up to 70% of patients with autoimmune rheumatic diseases (ARDs), including rheumatoid arthritis, psoriatic arthritis, and systemic lupus erythematosus, report moderate to severe pain despite controlled inflammation, driving interest in self-management including use of cannabis. We applied natural language processing (NLP) to 2.6 million electronic health record notes from 5051 adults with ARDs seen at a tertiary health center. NLP classified cannabis documentation as current, past, or none and identified reasons (pain, sleep, anxiety, nausea, appetite). Classifiers achieved an F1 score of 0.85 for current versus past use and 0.83 for reasons, indicating a high level of accuracy. From 2004-2024, notes documenting current use rose from 0.1% to 1.1% (a 900% increase. Overall, 1237 patients (24.5%) had ≥ 1 note of current use; prevalence was higher among Hispanic/Latino (30.1%) and Black (36.2%) patients than White (26.5%). Pain was the leading motive (37.9%), especially among Black (54.5%) and Hispanic/Latino (43.2%) patients, and women more often cited use for pain (39.4% vs. 33.0%) and sleep (16.4% vs. 11.6%) than men. Cannabis users had higher comorbidity indices, more emergency visits (2.1 vs. 1.3 per patient-year) and hospitalizations (1.4 vs. 0.9), and more opioid prescriptions (65% vs. 32.7%). These findings suggest rising cannabis use for ARD pain management and significant sociodemographic disparities, underscoring the need for prospective studies to assess outcomes and inform guidelines. PERSPECTIVE: This study demonstrates the feasibility of using natural language processing to extract real-world evidence on cannabis use in autoimmune rheumatic diseases. Findings reveal increasing documentation and sociodemographic disparities, underscoring the need for standardized recording and prospective studies to evaluate safety, effectiveness, and equitable access to cannabis-based symptom management.
(Copyright © 2025 United States Association for the Study of Pain, Inc. Published by Elsevier Inc. All rights reserved.)

Conflict of Interest The authors have no other conflicts of interest to declare.