接受美沙酮维持治疗的患者中大麻使用与治疗结果之间的关联：一项系统评价方案
Association between cannabis use and treatment outcomes in patients receiving methadone maintenance treatment: a systematic review protocol.
作者信息
Zielinski Laura, Bhatt Meha, Eisen Rebecca B, Perera Stefan, Bhatnagar Neera, MacKillop James, Steiner Meir, McDermid Vaz Stephanie, Thabane Lehana, Samaan Zainab
机构信息
MiNDS Neuroscience Graduate Program, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
Health Research Methodology Graduate Program, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
出版信息
Syst Rev. 2016 Aug 16;5(1):139. doi: 10.1186/s13643-016-0317-2.
BACKGROUND
With the non-medical use of prescription opioids increasingly becoming a method of abuse in Canada, the number of patients requiring methadone maintenance treatment (MMT) for opioid use disorder has increased dramatically. The rate of cannabis use in this population is disproportionately high (~50 %). Because its use is generally perceived as harmless, cannabis use is often not monitored during MMT. Current literature regarding the effects of cannabis use on MMT is conflicting, and the presence and nature of an association has not been clearly established. The primary objective of this review will be to conduct a systematic review of the literature and, if appropriate, a meta-analysis to determine whether there is an association between cannabis use and MMT outcomes. A secondary objective will be to perform subgroup analyses (by age, sex, method of cannabis measurement, and country) to determine whether cannabis use differentially influences MMT outcomes within these subgroups.
METHODS/DESIGN: The search will be conducted on the following electronic databases using a predefined search strategy: MEDLINE, EMBASE, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Two authors (LZ and MB) will independently screen articles using predetermined inclusion/exclusion criteria and will extract data from included articles using a pilot-tested data extraction form. Disagreements at all stages of the screening process will be settled through discussion, and when consensus cannot be reached, a third author (ZS) will be consulted. An assessment of quality and risk of bias will be conducted on all included articles, and a sensitivity analysis will be used to compare results of studies with high and low risk of bias. We will perform random- and fixed-effects meta-analyses, if appropriate, with heterogeneity calculated using the I (2) statistic and formal evaluation of publication bias.
DISCUSSION
Results of this systematic review will elucidate the association between cannabis use and methadone maintenance treatment outcomes. We will provide evidence that will be useful to clinicians regarding whether monitoring cannabis use during MMT is advantageous for optimizing MMT outcomes.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42015029372.
背景
在加拿大，处方阿片类药物的非医疗使用日益成为一种滥用方式，因阿片类药物使用障碍而需要美沙酮维持治疗（MMT）的患者数量急剧增加。该人群中大麻使用率高得不成比例（约50%）。由于大麻使用通常被认为无害，在美沙酮维持治疗期间往往不对其使用情况进行监测。目前关于大麻使用对美沙酮维持治疗影响的文献存在矛盾，且两者之间关联的存在及性质尚未明确确立。本综述的主要目的是对文献进行系统综述，并在适当情况下进行荟萃分析，以确定大麻使用与美沙酮维持治疗结果之间是否存在关联。次要目的是进行亚组分析（按年龄、性别、大麻测量方法和国家），以确定大麻使用在这些亚组中是否对美沙酮维持治疗结果有不同影响。
方法/设计：将使用预定义的检索策略在以下电子数据库中进行检索：MEDLINE、EMBASE、PsycINFO和护理学与健康相关文献累积索引（CINAHL）。两位作者（LZ和MB）将使用预定的纳入/排除标准独立筛选文章，并使用经过预试验的数据提取表从纳入的文章中提取数据。筛选过程各阶段的分歧将通过讨论解决，若无法达成共识，将咨询第三位作者（ZS）。将对所有纳入文章进行质量和偏倚风险评估，并使用敏感性分析比较高偏倚风险和低偏倚风险研究的结果。若合适，将进行随机效应和固定效应荟萃分析，使用I²统计量计算异质性并对发表偏倚进行正式评估。
讨论
本系统综述的结果将阐明大麻使用与美沙酮维持治疗结果之间的关联。我们将提供证据，以帮助临床医生判断在美沙酮维持治疗期间监测大麻使用是否有利于优化美沙酮维持治疗结果。
系统综述注册
PROSPERO CRD42015029372
Zotero 插件