title: Social correlates of health status, quality of life, and mood states in patients treated with cannabidiol for epilepsy.
abstract: Social characteristics, such as socioeconomic status and race/ethnicity, play a role in the treatment and outcomes of patients with epilepsy (PWE), but little is known about how these factors affect patients receiving cannabidiol (CBD) to treat seizures. This exploratory study examined the sociodemographic profile of patients treated with CBD (n=80) and associations between social factors and patient-centered outcomes - overall health status, Quality of Life in Epilepsy-89 (QOLIE-89), and Profile of Mood States (POMS) - in this population. Associations were examined using Pearson correlations and multiple ordinary-least-squares regression (alpha=0.1). The sample was predominantly white (96%) and non-Hispanic/Latino (96%); 76% of patients had family incomes of $40,000+/year. Some patients/families reported experiencing food scarcity (13%), not being able to make ends meet (6%), or not being able to afford antiepileptic medications (8%). The patients' health ratings declined with age and income (p≤0.014), and there was a statistically significant interaction (p<0.055) between these variables: for example, a higher-income 10-year-old had a predicted health rating of 3 ("very good"), followed by a higher-income 40-year-old with a rating of 2 ("good"), a low-income 10-year-old with a rating of 1 ("fair"), and a low-income 40-year-old with a rating of 0 ("poor"). This is the first study reporting the social profile of patients taking pharmaceutical grade CBD for the treatment of epilepsy. The results suggest that despite free access to this treatment some patients may not be accessing CBD because of their socioeconomic situation or race/ethnicity. Larger, diverse samples and longitudinal data are needed to more accurately model social factors and patient-centered outcomes in PWE receiving CBD. This article is part of a Special Issue entitled "Cannabinoids and Epilepsy".
authors.affiliation: Department of Sociology, University of Alabama at Birmingham, HHB 460H, 1720 2nd Ave South, Birmingham, AL 35294-1152, USA. Electronic address: szaflam@uab.edu.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Szaflarski
authors.affiliation: Department of Sociology, University of Alabama at Birmingham, HHB 460H, 1720 2nd Ave South, Birmingham, AL 35294-1152, USA. Electronic address: barbarap@uab.edu.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hansen
authors.affiliation: UAB Epilepsy Center, Department of Neurology, University of Alabama at Birmingham, 312 Civitan International Research Center (CIRC 312), 1720 2nd Avenue South, Birmingham, AL 35294-0021, USA. Electronic address: ebebin@uabmc.edu.
authors.forename: E Martina
authors.initials: EM
authors.lastname: Bebin
authors.affiliation: UAB Epilepsy Center, Department of Neurology, University of Alabama at Birmingham, 312 Civitan International Research Center (CIRC 312), 1720 2nd Avenue South, Birmingham, AL 35294-0021, USA. Electronic address: szaflaj@uab.edu.
authors.forename: Jerzy P
authors.initials: JP
authors.lastname: Szaflarski
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect / Q000187:drug effects* / Q000502:physiology; D000927:Anticonvulsants / Q000627:therapeutic use; D002185:Cannabidiol / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D000069279:Drug Resistant Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012640:Seizures / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D012923:Social Class; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D002185:Cannabidiol
keywords: Cannabidiol; Epilepsy; Health disparity; Patient-centered outcomes; Quality of life; Social determinants of health