The Pharmaceutical Journal
Vol 276 No 7404 p672
10 June 2006

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NPSA reissues guidance on oral methotrexate

Almost one in five NHS organisations in England and Wales has failed to implement National Patient Safety Agency recommendations to reduce the risk of harm associated with incorrect use of oral methotrexate. To address this, the NPSA has reissued its guidance in a new safety alert entitled “Improving compliance with oral methotrexate guidelines”. The alert tells NHS organisations to:

· Ensure that all actions described in the original alert are completed

· Give patients the patient information leaflet and monitoring document reviewed in collaboration with the British Society for Rheumatology and the British Association of Dermatologists

The NPSA says that feedback from the Department of Health’s safety alert broadcast system indicates that around 18 per cent of NHS organisations (104 out of 569) have not fully implemented the recommendations set out in the original alert issued two years ago (PJ, 31 July 2004, p137 and p144).

Since then, the NPSA has received 165 reports of patient safety incidents involving oral methotrexate via its national reporting and learning system, most of which (151) happened after the alert had been issued.

The NPSA’s medical director, Sir John Lilleyman, commented: “Progress has been made since the original alert was issued in July 2004. However, incidents may have been prevented if action had been taken.”