Methotrexate: improving safety profile

Area of Science:

• Dermatology
• Pharmacology
• Patient Safety

Background:

• Methotrexate is a common treatment for psoriasis.
• Patient safety incidents linked to methotrexate prescribing are a growing concern globally.
• Previous audits indicate issues with methotrexate prescribing practices.

Purpose of the Study:

• To audit current methotrexate prescribing practices for psoriasis patients within the department.
• To identify areas for improvement in patient information and monitoring.
• To develop evidence-based guidelines to enhance patient safety.

Main Methods:

• Retrospective audit of 49 psoriasis patients on methotrexate.
• Review of departmental prescribing practices and documentation.
• Literature review of current evidence and guidelines from leading centers.

Main Results:

• Inadequate documentation regarding patient information on methotrexate complications.
• Inconsistencies in prescribing practices, particularly concerning hematological monitoring.
• Identification of procollagen peptide III as a useful marker for monitoring liver toxicity.

Conclusions:

• Development of consistent, evidence-based guidelines is crucial for minimizing methotrexate complications.
• Updated guidelines should incorporate newer monitoring methods like procollagen peptide III.
• Further audits are recommended to ensure adherence to new guidelines and improve patient safety.