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AB1082-HPR Providing Drug Counselling on Methotrexate Is One Occasion Enough?
  1. S.J. Ryan,
  2. C. Thwaites,
  3. S. Kamath
  1. Rheumatology, Haywood Hospital, Stoke on Trent, United Kingdom


Background Methotrexate is used in the treatment of patients with an active inflammatory arthritis. Patients routinely receive drug information on the commencement of treatment, often from the rheumatology nurse specialist, and can remain on Methotrexate for many years if it remains safe and effective. Despite the long duration of use of Methotrexate there is often no mechanism to reinforce information about continuing to take the medication safely.

Objectives The aim of this survey was to establish what safety information patients recalled receiving about Methotrexate and whether patients would like to be updated with information about taking this medication.

Methods A questionnaire was developed and distributed to patients attending for their Methotrexate drug monitoring appointment in a rheumatology community hospital. The content of the questionnaire focused on:

a) The side effects patients had been asked to report.

b) When methotrexate could be safely taken (including pregnancy, alcohol intake, influenza vaccination and contraceptive precautions).

c) What action would be taken if a problem related to their Methotrexate occurred.

4) Whether patients would like to be updated with information about Methotrexate and if so how they would like to be updated and what information they would want to be included.

Results The survey was completed by 100 patients on Methotrexate. The majority of the respondents (58%) were over 61 years and had been taking Methotrexate for longer than a year. Ony 35% of respondents recalled being asked to report shortness of breath and only 42% would report the presence of infection. Forty one per cent of respondents felt a small amount of alcohol was safe. Although all respondents stated that Methotrexate should not be taken in pregnancy, sixty seven percent of respondents did not know whether contraceptive precautions should be taken. Eighty eight percent of respondents would contact the rheumatology adviceline with a problem and 27% of respondents did not know whether it was safe to have the influenza vaccination. Eighty six per cent of respondents would like to be updated with information about Methotrexate with 83% requesting written information on any aspect that would enhance the safe taking of Methotrexate.

Conclusions The majority of patients taking Methotrexate would not report shortness of breath or the presence of infection, both serious events that would require the Methotrexate to be stopped. It would appear that there is a need to update patients with safely information when they remain on Methotrexate for many years. Patients would welcome being updated with written information to enhance the safe taking of this medication. Further research would be required to identify if providing information at regualr intervals did improve the reporting of side effects and the safe administration of Methotrexate.

Disclosure of Interest None declared

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