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. 2021 Sep-Oct;40(5):316-321.
doi: 10.1097/NOR.0000000000000792.

Methotrexate Intolerance: A Complex Belief System

Elizabeth Salt  1   2   3 , Kristine Lohr  1   2   3 , Jean Edward  1   2   3
Affiliations

Methotrexate Intolerance: A Complex Belief System

Elizabeth Salt et al. Orthop Nurs. 2021 Sep-Oct.

Abstract

An estimated 11%-33% of persons taking methotrexate for rheumatoid arthritis (RA) are intolerant to this medication. Medications for RA are often discontinued or changed because of patient intolerance. Yet, intolerance is a poorly defined perspective, specifically the patient's perspective. This study used descriptive qualitative methodologies to describe methotrexate intolerance from the perspective of adult patients with RA. Semistructured, audio-recorded individual interviews were conducted with 14 adult English-speaking patients with RA who had been prescribed, were taking, or had ever taken methotrexate. Methotrexate intolerance involves a complex belief system involving 3 themes: beliefs about the risk of methotrexate, beliefs about the benefits of methotrexate, and beliefs about the threat of RA. Participants reported a threshold by which perceived risks and benefits of methotrexate were weighed against perceived risks of RA. The critical underpinnings of the largely undefined and unique patient perspective of methotrexate intolerance are described.

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Conflict of interest statement

Conflicts of interest/Competing interests: The results of this study discuss medications manufactured by Pfizer, Inc. With this being said, results reflect unedited perspectives of patients with rheumatoid arthritis. Elizabeth Salt, PhD, APRN, Kristine Lohr, MD, and Jean Edward, PhD, RN, CHPE, are employees of the University of Kentucky, Lexington, KY, which received financial support from Pfizer, Inc., in connection with this research and the development of the manuscript.

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