Administering subcutaneous methotrexate for inflammatory arthritis

Published: 19 December 2012

RCN guidance document to be updated

At last year’s forum committee strategy meeting in November 2011, there was a general consensus that this RCN guidance document Administering Subcutaneous Methotrexate for Inflammatory Arthritis (PDF 602 KB) needed updating as it was produced and published in April 2004 and there has been continuing development during this time pertaining to the drug’s administration as well as changes in license for various inflammatory conditions. It also felt timely for the document to be updated and developed for use by all health care professionals working within primary, secondary and tertiary care settings.

Once updated and developed, this document will provide practitioners with current evidence, the aim of which is to enhance practitioners’ knowledge further and promote best clinical practice for the safe administration of subcutaneous methotrexate for inflammatory arthritis.

First meeting

In October 2012, the first task and finish group meeting was held at RCN HQ in London. The attendees at that meeting included the following task and finish group members: 

• Committee member and Project Chair, CNS Rheumatology Lisa Howie
• Forum Chair, CNS Rheumatology Vicky Chamberlain
• Committee member, CNS Rheumatology Ruth Slack
• Paediatric Rheumatology CNS Polly Livermore
• Community Rheumatology CNS Deborah Lloyd
• Paediatric Rheumatology CNS Pam Whitworth
• Paediatric Rheumatology CNS Helen Strike
• Writer Sarah Feneck 
• RCN Long Term Conditions Adviser Amanda Cheesley.

Also present were:

• RCN Nursing Co-ordinator for the Nursing Department Edward Eaton
• RCN Nursing Co-ordinator for the Nursing Department Sarah Stanley
• RCN Corporate Relations Account Manager Sally Faley.

Putting together a plan

The aim of the first meeting was to meet and agree on the project’s aims and objectives and develop an action plan. We aim to have the document scrutinised externally by an independent panel of experts, which we anticipate to be in November/ December 2013 and which will hopefully include:

• Independent Rheumatology Nurse Consultant Sue Oliver 
• Ailsa Bosworth – NRAS Patient Group representation
• Dr Clarissa Pilkington – BSPAS representation
• Rose Gallagher, RCN Infection Control Adviser
• Dr Stewart E Glaspole – Lead Pharmacist in Health Economy Prescribing, Teacher Practitioner KSS Pharmacy Foundation Programme, Specialist Interest – Rheumatology, Brighton and Sussex University Hospitals NHS Trust, Brighton and Hove City PCT, University of Brighton
• Rebecca Cheatle, RCN Primary Care Adviser.  [end bullet points]

Publication launch venues and dates

Plans have been put in place for the updated version of the document to be launched at the following conferences: 

• BSR/BHPR Annual Conference 2013 – Rheumatology 2013, 23–25 April 2013 at ICC, Birmingham
• RCN Congress 2013 – Liverpool Arena and Convention Centre (ACC), 21–25 April 2013 – Fringe meeting exhibition launch.

Launch event aims

• to launch and raise awareness of the updated version of this RCN guidance document
• to promote the reference and use of the document for best clinical practice and audit purposes
• to increase practitioners’ understanding and awareness of what evidence-based changes have been made to the document, particularly in improving best clinical practice and enhancing practitioners’ confidence regarding the safe administration of subcutaneous methotrexate for inflammatory arthritis.

Learning outcomes

It is anticipated that the health care practitioners attending either of the above launches, will:

• gain increased knowledge and awareness of, access and exposure to, the updated RCN guidance document
• gain greater understanding and knowledge of the document’s aims, purpose and use as an evidence-based, best practice guidance document aimed at increasing practitioners’ knowledge and the promotion of the safe and confident administration of subcutaneous methotrexate (and the audit of same)
• engage in networking and discussions with some of the members of the subcutaneous methotrexate document update group and other healthcare professionals.

Thank you all for taking the time to read the above document update report. We look forward to seeing you at one of the above conferences, where you will have a more personal opportunity to view and discuss the updated document.