Methotrexate Safety Improvement in Nursing Home Residents

Journal of the American Medical Directors Association

Volumn 13, Issue 1, 2012, Pages 69-74

  Zarowitz, Barbara J ^a   Erwin, W Gary ^a   Ferris, Mindy ^b   Losben, Nancy ^b   Proud, Terri ^b  

^a Services Omnicare Inc   (United States)

^b Omnicare Inc   (United States)

Author keywords

Adverse events; Methotrexate; Nursing home; Quality improvement; Safety

Indexed keywords

ALTRETAMINE; BLEOMYCIN; CISPLATIN; CORTICOSTEROID; CYCLOPHOSPHAMIDE; CYCLOSPORIN; CYTARABINE; DEXAMETHASONE; DOXORUBICIN; ETOPOSIDE; FLUOROURACIL; LOMUSTINE; METHOTREXATE; MIFEPRISTONE; NAVELBINE; PREDNISONE; TACROLIMUS; VINBLASTINE; VINCRISTINE;

ACUTE LYMPHOCYTIC LEUKEMIA; ARTICLE; ASTHMA; BILIARY CIRRHOSIS; BLADDER CANCER; BREAST CANCER; BURKITT LYMPHOMA; CARCINOMATOUS MENINGITIS; CHORIOCARCINOMA; COHORT ANALYSIS; COMPUTER PROGRAM; CROHN DISEASE; DERMATOMYOSITIS; DESMOID TUMOR; DRUG DOSE REDUCTION; DRUG DOSE TITRATION; DRUG MONITORING; DRUG SAFETY; ECTOPIC PREGNANCY; FIBROMATOSIS; FOLLOW UP; GRAFT VERSUS HOST REACTION; HEAD AND NECK CANCER; HOSPITAL PHARMACY; HUMAN; HYDATIDIFORM MOLE; JUVENILE RHEUMATOID ARTHRITIS; LEUKEMIC MENINGITIS; LUNG CANCER; MEDICAL EDUCATION; MEDICATION ERROR; MYCOSIS FUNGOIDES; NURSING HOME; NURSING HOME PERSONNEL; OSTEOSARCOMA; OVARY CANCER; PHARMACIST; POLYMYOSITIS; PRESCRIPTION; PSORIASIS; PSORIATIC ARTHRITIS; RHEUMATOID ARTHRITIS; SARCOIDOSIS; STAFF TRAINING; SYSTEMIC LUPUS ERYTHEMATOSUS; TOTAL QUALITY MANAGEMENT; ULCERATIVE COLITIS; UNSPECIFIED SIDE EFFECT;

EID: 84855193205     PISSN: 15258610     EISSN: 15389375     Source Type: Journal    
DOI: 10.1016/j.jamda.2010.08.006     Document Type: Article

References (14)

1. Methotrexate. Clinical Pharmacology On-Line. Gold Standard, Inc. Available at: Accessed April 7, 2010. http://www.clinicalpharmacology.com.
2. Pisetsky D.S., St.Clair E.W. Progress in the treatment of rheumatoid arthritis. JAMA 2001, 286:2787-2790.
3. Moore T.J., Walsh C.S., Cohen M.R. Reported medication errors associated with methotrexate. Am J Health Syst Pharm 2004, 61:1380-1384.
4. Methotrexate Tablets, USP. Product Information 2009, Major Pharmaceuticals, Livonia, MI.
5. National Patient Safety Agency. Patient safety alert (13). Improving compliance with the oral methotrexate guidelines. Available at: Accessed April 7, 2010. http://www.nrls.npsa.nhs.uk/resources/?entryid45=59800&q=0%c2%acmethotrexate%c2%ac.
6. Harris W. Methotrexate-associated medication errors. Am J Health Syst Pharm 2004, 61:2635.
7. ISMP Medication Safety Alert. Beware of erroneous daily oral methotrexate dosing April 3, 2002, Institute for Safe Medicine Practices, Available at, Accessed April 7, 2010. http://www.ismp.org/Newsletters/acutecare/articles/20020403.asp.
8. Institute for Safe Medicine Practices. ISMP's List of Error-Prone Abbreviations, Symbols, and Dose Designations. Available at: Accessed April 7, 2010. http://www.ismp.org/Tools/errorproneabbreviations.pdf.
9. Saag K.G., Teng G.G., Patkar N.M., et al. American College of Rheumatology 2008 recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis. Arthritis Rheum 2008, 59:762-784.
10. Choosing medications for adults with rheumatoid arthritis. Agency for Healthcare Research and Quality April 2008, Effective Health Care, Available at, Accessed April 7, 2010. http://www.ahrq.gov.
11. Visser I.K., Katchamart W., Loza E., et al. Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: Integrating systematic literature research and expert opinion of a broad international panel of rheumatologists of the 3E initiative. Ann Rheum Dis 2009, 68:1086-1093.
12. Omnicare, Inc. 2009 Annual Report, Omnicare, Inc., Covington, KY. Available at: Accessed September 22, 2010. http://ir.omnicare.com/phoenix.zhtml%3Fc%3D65516%26p%3Dirol-reportsAnnual.
13. Zarowitz BJ. Delivery of Dialysis Treatment in Long Term Care Facilities. Presented to Dr. Barry Straub, Director, Office of Clinical Standards and Quality, and Mr. Thomas Hamilton, Director of CMS Survey and Certification, Centers for Medicaid & Medicare Services, Bethesda, MD, October 17, 2008.
14. Sinicina I., Mayr B., Mall G., Keil W. Deaths following methotrexate overdoses by medical staff. JRheumatol 2005, 32:2009-2013.