A recently published study in the British Journal of General Practice has concluded that the prevalence of unsafe methotrexate prescribing has reduced but remains common. The study also indicates that there is still substantial variation between practices and CCGs.
The study was a retrospective cohort study of English GP prescribing data (August 2010–April 2018), and data acquired via freedom of information (FOI) requests. The background to the study was that to minimise risk, it has been recommended for some years only 2.5 mg tablets are used.
Of 7349 practices in England, 1689 prescribed both 2.5 mg and 10 mg tablets to individual patients in 2017, breaching national guidance.
Twenty-one deaths caused by methotrexate poisoning were reported from 1993–2017 in England and Wales.
The authors recommend investment in better strategies around implementation. The authors also recommend that the coroners’ reports for these deaths should be reviewed to identify recurring themes.