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David S Sanders, Joshua R Ehrlich, Taylor Blachley, Theresa Cooney, Joshua D Stein; Increased Incidence of Glaucoma Diagnosis Following Passage of Medical Marijuana Legislation. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© ARVO (1962-2015); The Authors (2016-present)
Glaucoma is an approved indication for medical marijuana prescription in select US states. We sought to determine whether there was a higher incidence of glaucoma diagnoses in states that passed medical marijuana legislation, as this may indicate patients are seeking a diagnosis in order to obtain medical marijuana.
We analyzed data from a US managed care claims database (2001-2012). We identified 6 states that passed medical marijuana legislation with glaucoma as an approved condition: AZ, DC, MI, NJ, NM, and RI. We matched patients from these states 1:1 based on age, race, and year of plan entry to others from states with no such laws. All enrollees were required to have at least 5 years of continuous enrollment. We assessed incident glaucoma diagnoses in the 2.5 years prior to vs. 2.5 years after legislation passage in states with laws and a similar 5 year time frame for states without laws. We used repeated measures multivariable logistic regression to assess odds of glaucoma diagnosis with key predictors of residence in a state with legislation and time.
Of 80188 beneficiaries in states that passed legislation, there were 1734 (2.2%) and 3050 (3.8%) glaucoma diagnoses in the 2.5 years prior to and the 2.5 years after legislation passage, respectively. Of 80188 beneficiaries in states that did not pass legislation, there were 1658 (2.1%) and 2758 (3.4%) glaucoma diagnoses in the earlier and later 2.5 year time periods, respectively. After adjusting for sex, income and education level, the odds of receiving a glaucoma diagnosis were 71% higher in the later vs. earlier 2.5 year time period in all states (OR=1.71; CI=1.63-1.79; p<0.0001). The odds of receiving a glaucoma diagnosis among persons in a state with the legislation increased 76% from pre-legislation to post-legislation (OR=1.76; CI=1.66-1.88; p<0.0001). Persons in states where legislation passed had 8% greater odds of receiving a glaucoma diagnosis than those in comparison states (OR=1.08; CI=1.03-1.12; p=0.0004).
The odds of receiving a glaucoma diagnosis were higher among patients residing in states that passed medical marijuana legislation than those states that did not pass such legislation and in years following legislation passage. Further research is warranted to determine if some patients living in states with laws are seeking out glaucoma diagnoses in order to obtain access to medical marijuana.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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