We read with great interest the recent letter entitled “Is parenteral methotrexate worth trying?” by Osman and Mulherin.1 There has been an increased use of intramuscular methotrexate (IM-MTX) in our department in the past two years, leading to an increased workload in the nurse-led monitoring clinics and in the cost. This has prompted us to review the clinical utility of switching patients to IM-MTX. In addition, we have recorded patients' experiences, focusing chiefly on patient satisfaction, with this treatment.

Medical case notes of 31 patients who had started treatment with IM-MTX, identified from our database, were examined. The clinical diagnosis, previous drug treatment, reason for changing to IM-MTX, efficacy, and side effects were noted. In addition, the patients were asked to complete a questionnaire, looking at patient satisfaction and preferred venue for injections (monitoring clinic or local doctor's …