The implementation of risk management measures for methotrexate by community pharmacists in Jordan: A cross-sectional study

Background Methotrexate (MTX) is a dangerous drug that can cause serious adverse effects. It is teratogenic and contraindicated during pregnancy. Community pharmacists play a key role in MTX risk management and in ensuring its safe and effective use. This research aims to explore the levels of implementing the required measures to provide MTX safely by community pharmacists in Jordan. Methods This was a cross-sectional questionnaire-based study. The study population comprised all pharmacists and pharmacy technicians working at community pharmacies in Amman, Jordan. A questionnaire designed to capture the intended outcomes was developed by the researchers based on a review of the essential measures needed to dispense MTX safely. Results A low level of adherence to implementing risk management measures was generally observed among research participants. Notably, 95.1% reported that they rarely request a negative pregnancy test from young female patients before dispensing MTX. Counselling the patients about the impact of taking MTX during pregnancy and the need to avoid breastfeeding while taking MTX were the most widely implemented risk management measures (although still sub-optimal). Counselling about avoiding infections and regarding sun exposure was provided by almost 50% of research participants for each measure. Conclusion Findings of this study are alarming, and they call for certain revisions of the current pharmacy practice in Jordan when it comes to dispensing high-risk medications. Based on the findings of the current study, several practice-related recommendations can be proposed to enhance the safe dispensing of MTX in community pharmacy settings.