Rheumatologist advice key to overcoming methotrexate fears and misconceptions


Rheumatologists are the most influential source of information about methotrexate for patients with rheumatoid arthritis and the most likely to provide positive information to overcome  myths and misconceptions about its safety, research shows.

For some patients the fear of potential adverse effects may limit use of the DMARD, according to a paper by a group of Australian rheumatologists.

According to a survey of 742 people in the Australian Rheumatology Association Database (ARAD), people who had used methotrexate obtained mostly positive information regarding the drug from rheumatologists (92%), GPs (66%), and educational websites (56%).

Just under half of the respondents (47%) reported that they received mostly positive information from pharmacists.

People seeking information about the drug were less likely to use informal sources but when they did, they were more likely to receive negatively skewed information from family members (61%), social media (60%), internet chat rooms (59%) and friends (52%).

The study, led by Dr Nieves Leonardo of the Queen Elizabeth Hospital, Adelaide, found patients typically consulted three information sources – which had the potential to increase confusion and concerns about methotrexate treatment.

People who used a greater number of information sources were typically younger, more educated and with higher concerns about general medicine harms and specifically about methotrexate according to their responses to a Beliefs about Medicine Questionnaire (BMQ).

“In our study, educational websites were influential to a patient’s belief that MTX treatment was necessary, whereas information sourced from internet chat rooms appeared to be linked with both an underestimation of the necessity for MTX and a heightening of concerns about its use due to the adverse events.”

The study said information from rheumatologists can help with patients’ decision-making about methotrexate by “…alleviating concerns, reducing perceived barriers, and strengthening the belief that it is needed for optimal treatment.”

“Good-quality multimedia information sources from treating specialists may also improve patient knowledge and help overcome fear.”

“It is therefore important for treating doctors to provide and/or direct patients to appropriate and accurate information sources, such as the Australian Rheumatology Association patient information sheets and Arthritis Australia.”

The study, published in the International Journal of Rheumatic Diseases, said data from the survey has been in materials developed by the National Prescribing Service (NPS), in collaboration with the Australian Rheumatology Association (ARA) and Arthritis Australia.

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