GPs win award for drug ‘alert’ card

A project designed to promote safer use of a potentially deadly medication has won a quality award.

Designed by Cork GPs Dr Diarmuid Quinlan and Dr Paul Ryan, the project involves a high-vis “alert” card, the same size as a driving licence, for patients on methotrexate, a potent drug commonly used to treat rheumatoid arthritis and psoriasis.

If taken in the wrong dose, the drug is potentially lethal. Dr Quinlan and Dr Ryan were given the ICGP Quality Award 2013 for their endeavours.

“The Irish College of General Practitioners (ICGP), in giving us the award, said our alert system may well save lives,” Dr Quinlan said.

The card contains patient information, including diagnosis, medications, side effects, and, crucially, what action to take if unwell.

“If patients taking this drug start to feel unwell, experience sweating, nausea or easy bruising or bleeding, it could be serious and they need to contact their GP,” Dr Quinlan said.

In making the award, ICGP medical director Dr Margaret O’Riordan said the project had helped ensure patients on the drug underwent an appropriate number of blood tests.

Because methotrexate, (brand names Rheumatrex, Trexall) can affect the liver, liver function tests are carried out regularly.

However, Dr Quinlan said patients can sometimes neglect this aspect of their treatment. The card is designed to help address this.

An audit of data as part of the project demonstrated appropriate blood testing improved and in some patients, excessive blood testing was curtailed, maintaining patient safety while reducing practice workload, said Dr O’Riordan.

Prescribing compliance also improved. Dr Quinlan said tablet strength confusion was a “huge problem”, especially among the elderly where eyesight may have deteriorated.

The alert card hopes to address this issue, as well as specifying a day of the week on which to take the weekly medication.

Taking the tablet daily in error, could be lethal, over time, Dr Quinlan said.