Most meds switched without much discussion

A new methotrexate usage survey shows that most patients with arthritis do not discuss medication modification strategies with their doctors. (©Photographee.eu/Shutterstock.com)

A new methotrexate usage survey shows that most patients with arthritis do not discuss medication modification strategies with their doctors.

The survey study was conducted by the Canadian Arthritis Patient Alliance (CAPA) and presented in June at the European Congress of Rheumatology/European League against Rheumatism (EULAR).

"Methotrexate is one of the first drugs that people are typically prescribed, sometimes with other drugs, when diagnosed with inflammatory arthritis, said Nathalie Robertson, a co-author of the study.

The survey, of 363 patients, also showed that 80% of patients do not discuss medication modification strategies with their healthcare providers. "That was a surprise. It makes you wonder why people would not want to talk to their doctor. Is it because the doctor is too busy? Do they think that if the doctor has prescribed the medication, there must be a way for them to figure it out themselves? CAPA is working to understand the answers to such questions," Ms. Robertson said.

Half of respondents agreed with the statement that they "do not like taking methotrexate, but it helps me manage my arthritis."

Patients reported avoiding milk or lactose, gluten, red meats, acidic, spicy or greasy foods, and alcohol. Other adaptation strategies include taking methotrexate with folic acid, or taking methotrexate before bed or on weekends, Ms. Robertson said. Additionally, "Some people take it on a full stomach. Some people drink lots of water; some might split a dose."

RESOURCE FOR PATIENTS
In early 2018 CAPA released a web resource featuring patient-derived tips and tricks for methotrexate use, in English, French and Spanish. This tool offers suggestions in areas such as diet and schedule modification. The tool's intent is to tell patients that there are modifications, such as dose splitting,  that they should discuss with their doctors, and others they can control on their own, said Ms. Robertson. As of early June, the web resource had drawn more than 600 visits.

REFERENCES
Dawn P Richards, Nathalie Robertson, Linda Wilhelm et al. "Development & Dissemination of a Resource about Methotrexate Use for and by Patients with Inflammatory Arthritis (Poster PARE0005)," Annual European Congress of Rheumatology/European League Against Rheumatism (EULAR). June 13-16, 2018.

Nathalie Robertson, Linda Wilhelm, Dawn P Richards, et al. "Canadian Arthritis Patient Alliance: Understanding Member Profiles and Needs (Poster PARE0009)," Annual European Congress of Rheumatology/European League Against Rheumatism (EULAR). June 13-16, 2018.