Successful implementation of a nurse-led teaching programme to independently administer subcutaneous methotrexate in the community setting to children with Crohn's disease.

Garrick, V., Atwal, P. , Barclay, A.R., McGrogan, P. and Russell, R.K. (2009) Successful implementation of a nurse-led teaching programme to independently administer subcutaneous methotrexate in the community setting to children with Crohn's disease. Alimentary Pharmacology and Therapeutics, 29(1), pp. 90-96. (doi: 10.1111/j.1365-2036.2008.03861.x) (PMID:18945263)

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Abstract

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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Russell, Dr Richard and Barclay, Prof Andrew and Atwal, Dr Paldeep
Authors: Garrick, V., Atwal, P., Barclay, A.R., McGrogan, P., and Russell, R.K.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Alimentary Pharmacology and Therapeutics
Publisher:Wiley
ISSN:0269-2813
ISSN (Online):1365-2036
Published Online:30 September 2008

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