{
  "abstract": "Background and Importance Methotrexate (MTX) is widely used in autoimmune and inflammatory diseases and often requires long-term administration. Folic acid supplementation is recommended to minimise adverse effects such as hepatotoxicity, gastrointestinal discomfort, and cytopenias. However, omission of folic acid remains a frequent prescribing error in clinical practice. Early detection of these cases is essential to prevent avoidable harm and to enable targeted pharmaceutical interventions.Aim and Objectives To identify primary care patients from our health area receiving MTX without folic acid supplementation and to describe their treatment characteristics.Material and Methods A retrospective descriptive study was conducted including 82 patients with active MTX prescriptions in August 2025 from the primary care population of our health area diagnosed with immune-mediated diseases. Variables collected included pharmaceutical form (oral or intramuscular), diagnosis, weekly MTX dose, and folic acid co-prescription status. Patients with oncohematologic diagnoses were excluded.Results A total of 82 patients were analysed, of whom 60 (73.2%) lacked folic acid supplementation. The mean weekly MTX dose was 10.6 mg in patients without folic acid and 13.2 mg in those supplemented. Thirty patients (36.6%) received high-dose MTX (≥15 mg/week), 19 of whom (63.3%) did not have folic acid prescribed. Among those without folic acid, MTX was mainly administered orally (33/60, 55%) or intramuscularly (26/60, 43%). The most common diagnoses were rheumatoid arthritis (37/60, 61.7%) and psoriatic arthritis (11/60, 18.3%).Conclusion and Relevance The majority of primary care patients in our health area receiving MTX lacked adequate folic acid supplementation, including those on high-dose regimens. These findings highlight the importance of systematic review of MTX prescriptions and active involvement of hospital pharmacy services in detecting and correcting potential prescribing omissions to improve patient safety.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofia, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "R Guzman Laiz"
    },
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofía, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "P Selvi Sabater"
    },
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofía, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "I García Masegosa"
    },
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofía, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "R Añez Castaño"
    },
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofía, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "A Herreros Fernández"
    },
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofía, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "E Santos Lopez"
    },
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofía, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "P Pascual García"
    },
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofía, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "E Urbieta Sanz"
    }
  ],
  "title": "5PSQ-068 Evaluation of methotrexate prescriptions in primary care: identification of patients without folic acid supplementation",
  "uid": "d909d04d-9e49-51e6-813e-71e765a9d8c0"
}