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Methotrexate: improving safety profile.

Claire Grills1, Susan Burge

  • 1Department Dermatology, Churchill Hospital, Oxford, UK. nandcgrills@optusnet.com.au

The Australasian Journal of Dermatology
|July 27, 2006
PubMed
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Methotrexate prescribing has led to patient safety incidents. An audit revealed poor documentation and inconsistent monitoring, prompting the development of new evidence-based guidelines to minimize drug complications.

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.

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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.