title: Sex differences in outcomes of methadone maintenance treatment for opioid addiction: a systematic review protocol.
abstract: BACKGROUND
  Use of methadone for the treatment of opioid addiction is an effective harm-reduction approach, although variability in treatment outcomes among individuals has been reported. Men and women with opioid addiction have been known to differ in factors such as opioid use patterns and characteristics at treatment entry; however, little has been reported about differences in methadone treatment outcomes between men and women. Therefore, we present a protocol for a systematic review which aims to provide a summary of existing literature on sex differences in outcomes of methadone treatment for opioid addiction.
  
  
  METHODS
  Electronic search of PubMed/MEDLINE, EMBASE, PsycINFO, and CINAHL databases will be conducted using a priori defined search strategy. Two authors (MB and BBD) will independently screen potential articles for eligibility using pre-determined inclusion and exclusion criteria and extract key information using a data extraction form designed for this study. Discrepancies will be resolved using a third party (ZS). The primary outcome will be sex differences in response to treatment defined as abstinence from illicit opioid use. We will also assess sex differences in treatment outcomes including treatment retention, remission status post-treatment, polysubstance abuse, methadone dose, drug-related adverse events, health status, psychological status, mortality, criminal activity, high risk sexual behavior, social support/relations, and employment. A meta-analysis will be conducted if possible; risk of bias and overall quality of evidence will be assessed to determine confidence in the estimates.
  
  
  CONCLUSIONS
  We anticipate that this review will highlight how men and women differ in methadone treatment outcomes and allow us to generate conclusions that can be applied to treatment in a clinical setting.
  
  
  BACKGROUND
  PROSPERO CRD42013006549.
authors.forename: Monica
authors.initials: M
authors.lastname: Bawor
authors.forename: Brittany B
authors.initials: BB
authors.lastname: Dennis
authors.forename: Rebecca
authors.initials: R
authors.lastname: Anglin
authors.forename: Meir
authors.initials: M
authors.lastname: Steiner
authors.forename: Lehana
authors.initials: L
authors.lastname: Thabane
authors.affiliation: Population Genomics Program, Chanchlani Research Centre, McMaster University, 1280 Main St, West, Hamilton, ON L8S 4L8, Canada. samaanz@mcmaster.ca.
authors.forename: Zainab
authors.initials: Z
authors.lastname: Samaan
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D012737:Sex Factors; D000078202:Systematic Reviews as Topic; D016896:Treatment Outcome
chemical_list: D009294:Narcotics; D008691:Methadone