|Improving Awareness of Monitoring and Education of Patients Prescribed Methotrexate in Respiratory Care
|S Burke, A Shahid, R Minogue, K Cooper, K Finan
|Sligo University Hospital
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|Methotrexate is a dihydrofolate reductase inhibitor used to treat a variety of autoimmune conditions. It has significant potential for adverse events. In respiratory medicine, BTS guidelines recommend its use to treat steroid dependent sarcoidosis. As use in a general respiratory clinic is rare, there can be a lack of formal monitoring systems in place.
We reviewed patients receiving methotrexate treatment for sarcoidosis in SUH respiratory clinic between 2018 and 2021 and assessed their adherence to blood monitoring. We subsequently created a questionnaire and assessed their knowledge of important adverse events and precautions. Of the six patients we identified, five did not meet the Health Products Regulatory Authority (HPRA) recommended blood monitoring requirements of three-monthly complete blood count and liver function tests. Only four were aware of the requirement for blood monitoring. Four were not aware of issues surrounding fertility or restrictions on vaccinations. Only three patients were aware of the risk of liver damage, and only one was aware of potential myelosuppression. None were aware of significant interactions with other medications.
Adapting pre-existing patient information leaflets and blood monitoring booklets developed by the local rheumatology service, we will now introduce these for use in our patients, aiming to improve patient education and monitoring.