Perceptions of methotrexate use in rheumatoid arthritis by rheumatologists and their patients: AN Australian survey study

Nash, Peter and Nicholls, Dave (2013) Perceptions of methotrexate use in rheumatoid arthritis by rheumatologists and their patients: AN Australian survey study. International Journal of Rheumatic Diseases, 16 6: 652-661. doi:10.1111/1756-185X.12183


Author Nash, Peter
Nicholls, Dave
Title Perceptions of methotrexate use in rheumatoid arthritis by rheumatologists and their patients: AN Australian survey study
Journal name International Journal of Rheumatic Diseases   Check publisher's open access policy
ISSN 1756-1841
1756-185X
Publication date 2013-01-01
Year available 2013
Sub-type Article (original research)
DOI 10.1111/1756-185X.12183
Open Access Status Not yet assessed
Volume 16
Issue 6
Start page 652
End page 661
Total pages 10
Place of publication Richmond, VIC 3121 Australia
Publisher Wiley-Blackwell Publishing Asia
Language eng
Subject 2745 Rheumatology
Abstract Aim: To improve treatment for rheumatoid arthritis (RA), rheumatologists have embraced patient-reported outcomes; however, limited data are available on patient perceptions of treatment. Our objective was to assess the use and perceptions of methotrexate (MTX) by patients with RA (primary objective) and their rheumatologists, patient-reported adverse events (AEs) related to MTX, and patient-reported use of alcohol, folic acid and biologic agents. Method: Each rheumatologist completed a rheumatologist questionnaire and then asked patients with RA to complete a patient questionnaire. Results: Questionnaires were completed by 46/50 rheumatologists and 1313/1313 patients. Patients (72% female, 38% > 10 years RA) took oral MTX regularly (72% never miss a dose) and at therapeutic doses. Most patients (79%) were currently taking MTX, but 36% of patients were on low doses (≤ 10 mg/week) and 8% intentionally and regularly did not take MTX. Most patients had a positive perception of MTX; 82% of patients considered MTX to be important; 60% preferred to continue taking MTX. Although AEs (generally mild and gastrointestinal) occurred regularly (38%) and in some patients continuously (13%), 41% of patients did not experience an AE. Patients abstained from alcohol (46%) and took folic acid (91%, but with variable dosage regimens and doses). There were 29% of patients taking biologic agent therapy; only 70% of these patients were also taking MTX. Conclusion: MTX was well used, well tolerated and well perceived. However, to ensure that MTX therapy is as effective as possible, rheumatologists should discuss MTX use with their patients and consider alternative strategies for some patients.
Keyword Arthritis rheumatoid
Methotrexate
Patient preferences
Survey health
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
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