The LLR ICS was signposted as being one of the country's worst prescribers of methotrexate 10mg tablets. Our project therefore aimed to stop the prescribing of methotrexate 10mg tablets in a safe manner across all healthcare sectors for Leicester, Leicestershire & Rutland ICS (LLR ICS) and in addition review the process in place for prevention of future prescribing of this strength by ensuring safety was addressed at system level for this medication. We recognised that this was a system wide problem rather than just an issue in primary care, hence we used this opportunity to develop relationships with colleagues in secondary care and community pharmacy, to find solutions together as a system.
Following the ICS actions, there was an 85% reduction in patients being prescribed the 10 mg strength of methotrexate.
This was achieved by being open and engaging with all sectors of the ICS with a unified system wide approach. Having a joint approach increased ‘buy-in’ from all sectors and established a ‘no blame’ culture. We recognised that this important safety message needed disseminating wider than our ICS, hence we collaborated with the local school of pharmacy (De Montfort University) in sharing our position statement and thereby capturing a wider future pharmacy professional audience.
