Sex differences in outcomes of methadone maintenance treatment for opioid use disorder: a systematic review and meta-analysis.
Sex differences in outcomes of methadone maintenance treatment for opioid use disorder: a systematic review and meta-analysis.
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DOI：
10.9778/cmajo.20140089
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发表时间：
2015-07-01
期刊：
影响因子：
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通讯作者：
Samaan, Zainab
中科院分区：
文献类型：
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作者：
Bawor, Monica;Dennis, Brittany B;Samaan, Zainab
背景：阿片类药物使用障碍是一个严重的国际问题，治疗成功率有限。男性和女性对阿片类药物使用障碍的易感性和对美沙酮治疗的反应不同，因此可以从性别特异性治疗中获益。我们进行了一个系统的文献回顾美沙酮维持治疗阿片类药物使用障碍的男性和女性的药物使用，健康状况和社会functioning.METHODS的结果：我们搜索PubMed，Embase，PsycINFO和CINAHL的观察或随机对照研究，涉及成年人18岁或以上接受美沙酮治疗阿片类药物使用障碍。如果研究调查了美沙酮治疗结果的性别差异，则纳入研究。两位作者独立审查和提取数据。在可能的情况下进行荟萃分析，偏倚风险和证据质量进行了assessed.RESULTS：20项研究，9732名参与者，其中18个观察和2个随机对照试验。男性和女性在饮酒方面存在显着差异（比值比[OR] 0.52，95%置信区间[CI] 0.31至0.86），安非他明使用（OR 1.47，95% CI 1.12 - 1.94）、法律的参与（OR 0.63，95% CI 0.47 - 0.84）和治疗期间就业（OR 0.39，95% CI 0.21 - 0.73）。男性和女性的阿片类药物使用模式相似。偏倚的风险是中度的，证据的质量普遍low.Interpretation：性别差异是显而易见的，在多种物质的使用，法律的参与和就业状况之间的男性和女性接受美沙酮治疗阿片类药物使用障碍。虽然证据质量较低，但我们的综述强调了改善性别特异性治疗策略的必要性。
BACKGROUND: Opioid use disorder is a serious international concern with limited treatment success. Men and women differ in their susceptibility to opioid use disorder and response to methadone treatment and can therefore benefit from sex-specific treatment. We performed a systematic review of the literature on outcomes of methadone maintenance treatment for opioid use disorder in men and women related to drug use, health status and social functioning.METHODS: We searched PubMed, Embase, PsycINFO and CINAHL for observational or randomized controlled studies involving adults 18 years of age or older undergoing methadone treatment for opioid use disorder. Studies were included if they investigated sex differences in methadone treatment outcomes. Two authors independently reviewed and extracted data. Meta-analyses were performed when possible; risk of bias and quality of evidence were also assessed.RESULTS: Twenty studies with 9732 participants were included, of which 18 were observational and 2 were randomized controlled trials. Men and women differed significantly in alcohol use (odds ratio [OR] 0.52, 95% confidence interval [CI] 0.31 to 0.86), amphetamine use (OR 1.47, 95% CI 1.12 to 1.94), legal involvement (OR 0.63, 95% CI 0.47 to 0.84) and employment during treatment (OR 0.39, 95% CI 0.21 to 0.73). Opioid use patterns were similar among men and women. Risk of bias was moderate, and quality of evidence was generally low.INTERPRETATION: Sex differences were evident in polysubstance use, legal involvement and employment status among men and women receiving methadone treatment for opioid use disorders. Although the quality of evidence was low, our review highlights the need for improved implementation of sex-specific treatment strategies.