Document Detail

Successful implementation of a nurse-led teaching programme to independently administer subcutaneous methotrexate in the community setting to children with Crohn's disease.
MedLine Citation:
PMID:  18945263     Owner:  NLM     Status:  In-Data-Review    
Background  Methotrexate is increasingly used as a third line immunosuppression agent in children with Crohn's disease (CD). Methotrexate is traditionally administered in the hospital setting. Aim  To set up a nurse-led education programme to teach children/their parents to administer subcutaneous methotrexate in the community. Methods  All patients were given methotrexate over a 16-month period. Patient demographics including previous treatments were collected. A competency based teaching package was implemented by the inflammatory bowel disease nurse. Distances and travel times together with costings were calculated. Results  Thirty two patients (19 male; 13 female) with a median treatment age of 11.96 years (IQR 10.67-13.92) were studied. Thirty of 32 (17 children, 13 parents) were independently administering methotrexate. The median return journey distance to hospital was 23 miles (IQR 14.4-42.4) taking a median time of 52 min (IQR 41.0-73.5) for each injection. The total patient travel saving was £10 537 (average £730 per patient) and nursing time saving was £12 808 with home administration (total saving £23 345). Conclusions  This paediatric study demonstrates that methotrexate injections can be given successfully in the majority (94%) of patients with CD independently in the community, resulting in significant time and money savings for patients and health professionals alike.
V Garrick; P Atwal; A R Barclay; P McGrogan; R K Russell
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Publication Detail:
Type:  Journal Article     Date:  2008-09-30
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  29     ISSN:  1365-2036     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2011-02-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  90-6     Citation Subset:  IM    
Copyright Information:
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd.
Department of Paediatric Gastroenterology, Yorkhill Hospital Division of Developmental Medicine, University of Glasgow, Glasgow, UK.
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