Understanding Gaps in Methotrexate Education in the Adolescent and Young Adult Population
Matthew Sholdice, Heather Bollegala, Meghan Pancucci, Karen Beattie, Michelle BatthishBackground:
Adolescents and young adults (AYAs) with rheumatic diseases (RD) may face challenges accessing and understanding information about methotrexate (MTX) and certain lifestyle choices, including drinking alcohol, using drugs, and sexual activity. We aimed to determine the knowledge, behaviours, and informational needs of AYAs taking MTX regarding alcohol/drug use and contraception.
Methods:
AYAs 16 to 25 years old taking MTX completed a questionnaire codesigned by AYAs with RD. Questionnaires were accessed through rheumatology clinics and social media.
Results:
Of 58 respondents, 78% were females, and 85% had JIA. In assessing knowledge of MTX, 28% were unaware that MTX can cause liver damage, and 87% agreed that alcohol should be avoided when taking MTX. The majority (80%) stated that contraception should be used if a female is taking MTX. Approximately one-quarter were unaware of the risk of birth defects while taking MTX. In assessing behaviours, 37% report drinking an average of 1 to 5 alcoholic drinks weekly. Sexual activity was reported by 58% of respondents, and almost all used contraception. Discomfort discussing alcohol use and sexual activity with their rheumatologist was reported by 20% and 32%, respectively. Respondents preferred to receive information from their rheumatologist/health care provider, the internet, and educational pamphlets. One-third reported not having access to accurate information regarding managing MTX side effects.
Conclusion:
AYAs often participate in at-risk behaviours while on MTX, which they do not discuss often with their rheumatologist. This study identified gaps and educational opportunities about MTX for AYAs, which can be shared through health care providers, online resources, or pamphlets.