Tolerability and Adherence Problems in Patients on a Stable Dose of Methotrexate: Results of a Multicentre Survey

Robinson, Sandra; Gibson, S; George, Emmanuel; Martin, Una; Heslop, Peta; Wrightson, H; Prowse, P; Kalinowski, Matthew; Marshall, David A.; Reed, Marty; Adebajo, Ade; Walker, David

doi:10.1002/msc.1129

Cited by 3 publications

(2 citation statements)

References 4 publications

(4 reference statements)

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“…Fatigue is a well-documented adverse effect of the medications used in this study. 16,37–39 It is also a symptom that patients find extremely distressing and can have a significant negative impact on quality of life. 40 Over the course of our trial, the vitality scores decreased by an average of 3.2 points for all patients.…”

Section: Discussionmentioning

confidence: 99%

Quality-of-Life Outcomes From a Randomized Clinical Trial Comparing Antimetabolites for Intermediate, Posterior, and Panuveitis

Niemeyer

Gonzales

Rathinam

et al. 2017

American Journal of Ophthalmology

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Purpose To evaluate the changes in quality of life in noninfectious uveitis patients treated with two of the most commonly prescribed antimetabolite treatments. Design Secondary analysis of a multicenter, block-randomized, clinical trial (ClinicalTrials.gov NCT01232920). Methods Eighty patients at Aravind Eye Hospitals in Madurai and Coimbatore, India, with noninfectious intermediate, posterior, or panuveitis were randomized to receive oral methotrexate, 25 mg weekly, or oral mycophenolate mofetil, 1 g twice daily, and were followed up monthly for 6 months. Best-corrected visual acuity, IND-VFQ, and SF-36 were obtained at enrollment and at 6 months (or prior in the event of early treatment failure). Results IND-VFQ scores, on average, increased by 9.2 points from trial enrollment to 6 months (95% CI: 4.9, 13.5, P =0.0001). While the SF-36 physical component summary score did not significantly differ over the course of the trial, the mental component summary score decreased by 2.3 points (95% CI: −4.4, −0.1, P=0.04) and the vitality subscale decreased by 3.5 points (95% CI: −5.6, −1.4, P=0.001). Quality of life scores did not differ between treatment arms. Linear regression modeling showed a 3.2 point improvement in IND-VFQ score for every 5 letter improvement in visual acuity (95% CI: 1.9, 4.3; P<0.001). Conclusions Although uveitis treatment was associated with increased vision and vision-related quality of life, patient-reported physical health did not change after 6 months of treatment, and, mental health decreased. Despite improved visual outcomes, uveitis patients receiving systemic immunosuppressive therapy may experience a deterioration in mental health-related quality of life.

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Section: Discussionmentioning

confidence: 99%

Quality-of-Life Outcomes From a Randomized Clinical Trial Comparing Antimetabolites for Intermediate, Posterior, and Panuveitis

Niemeyer

Gonzales

Rathinam

et al. 2017

American Journal of Ophthalmology

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“…Methotrexate is the most widely prescribed DMARD for rheumatoid arthritis and psoriatic arthritis (Bird, Griffiths, & Littlejohn, ) and education is particularly important because of its delayed effect and the significant risk of side effects, which can occasionally be fatal (Harrison & Jones, ; National Patients Safety Agency, ). There are also tolerability problems in more than half of regular takers, which may affect adherence (Robinson et al, ).…”

Section: Introductionmentioning

confidence: 99%

An exploration of the experiences of rheumatology nurses counselling patients on methotrexate therapy

Robinson

Ryan²,

Adams

et al. 2018

Musculoskeletal Care

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Participants reported that the majority of the consultation focused on conveying information, with little opportunity for patient interaction and questions. We suggest that there is a clear need for further exploration of these consultations, to identify possible training needs. Participants also used standard written information to guide both the structure and content of the consultation limiting patients'; opportunities to ask questions.

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Evidence-based practice is the gold standard and should be adhered to at all times—or should it?

Walker

Bukhari

2018

Rheumatology

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Tolerability and Adherence Problems in Patients on a Stable Dose of Methotrexate: Results of a Multicentre Survey

Abstract: Patients put up with a considerable number of side effects in order to benefit from methotrexate therapy. Adherence to this drug merits further study. Copyright © 2015 John Wiley & Sons, Ltd.

Cited by 3 publications

References 4 publications

Quality-of-Life Outcomes From a Randomized Clinical Trial Comparing Antimetabolites for Intermediate, Posterior, and Panuveitis

Quality-of-Life Outcomes From a Randomized Clinical Trial Comparing Antimetabolites for Intermediate, Posterior, and Panuveitis

An exploration of the experiences of rheumatology nurses counselling patients on methotrexate therapy

Evidence-based practice is the gold standard and should be adhered to at all times—or should it?

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