Pilot Study Measuring Patient Reported Outcomes in Cannabinoid Hyperemesis Syndrome (CHS) patients treated in the Emergency Department

Authors

Ryan Heidish, The George Washington University School of Medicine and Health Sciences, Department of Emergency Medicine, Washington, DC, USA.
Aditya Loganathan, The George Washington University School of Medicine and Health Sciences, Department of Emergency Medicine, Washington, DC, USA.
Taylor Bolden, The George Washington University School of Medicine and Health Sciences, Department of Emergency Medicine, Washington, DC, USA.
Ziva Cooper, UCLA Center for Cannabis and Cannabinoids, Los Angeles, CA, USA.
Meylakh Barshay, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Isabella Lagunzad, The George Washington University School of Medicine and Health Sciences, Department of Emergency Medicine, Washington, DC, USA.
Andrew C. Meltzer, The George Washington University School of Medicine and Health Sciences, Department of Emergency Medicine, Washington, DC, USA.

Document Type

Journal Article

Publication Date

12-2-2025

Journal

Clinical and experimental emergency medicine

DOI

10.15441/ceem.25.032

Abstract

OBJECTIVE: s Abdominal pain is the most common emergency department (ED) complaint, with many patients experiencing recurrent episodes due to Cannabinoid Hyperemesis Syndrome (CHS), a syndrome characterized by pain and vomiting in the setting of chronic cannabis use. This pilot aimed to demonstrate the ability to enroll patients with CHS, characterize patient-reported outcomes (PRO's), and estimate 30-day revisit rates. METHODS: This prospective observational study enrolled adult ED patients with CHS at an academic center and community affiliate. The inclusion required a prior diagnosis of CHS and ED clinician judgment that symptoms at time of enrollment were likely due to CHS. Exclusions included unstable clinical status or other high-risk conditions. Primary outcomes included a characterization of symptoms, assessment of multiple domains of PRO's, measurement of the use of both CT scans and opioid analgesia, and frequency of 30-day ED return visits. RESULTS: A total of 18 participants were enrolled (mean age 34 years; 55.6% female). Automated chart reviews were completed for each outcome of interest at 30 days and 12 months. Pain severity was high (mean triage pain score 6.4, SD = 4.3) and prior CT imaging was noted in 72.2% of participants in the past five years. Opioids were administered in 22.2% of cases, while PROMIS-29 scores highlighted high risks of anxiety (mean T-score 56.1, SD = 11.5) and how pain interfered with normal activities of living (T-score 62.2, SD = 11.1). Return visits occurred in 16.7% of participants (3/18) within 30 days. CONCLUSION: ED patients with CHS show significant burden on PRO's and high 30-day revisits. Future studies should consider interventions that address PRO's and reduce ED revisits.

APA Citation

Heidish, Ryan; Loganathan, Aditya; Bolden, Taylor; Cooper, Ziva; Barshay, Meylakh; Lagunzad, Isabella; and Meltzer, Andrew C., "Pilot Study Measuring Patient Reported Outcomes in Cannabinoid Hyperemesis Syndrome (CHS) patients treated in the Emergency Department" (2025). GW Authored Works. Paper 8458.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/8458

Department

Emergency Medicine