title: Patient self-injection of methotrexate for inflammatory arthritis: a study evaluating the introduction of a new type of syringe and exploring patients' sense of empowerment.
abstract: OBJECTIVE
  To evaluate the introduction of a new type of syringe for patients on a self-injection of methotrexate (MTX) programme and explore patients' sense of empowerment relating to the self-injection of MTX.
  
  
  METHODS
  Data were collected using a postal questionnaire, which yielded quantitative and qualitative data. The questionnaire was sent to all eligible patients in the primary care setting who self-injected MTX (n=24).
  
  
  RESULTS
  The response rate was 88% (n=21). Patients' responses illustrated numerous disadvantages of using the syringe, particularly difficulties with the syringe stopper, syringe handling and leakage potential of the mildly cytotoxic drug MTX. The advantages included the ease of syringe storage and longer use by date. Difficulties in using the syringe, and the amount of support and training from hospital staff were among the factors affecting patients' sense of empowerment.
  
  
  CONCLUSIONS
  Although a small study, this work indicates that there may be benefits in a collaboration between hospital staff and the syringe manufacturer, to modify the new syringe to address the problems noted. The potential of cytotoxic MTX spillage being minimized is recognized, making the new syringe more suitable for use by patients with inflammatory arthritis. Patient training may help to alleviate difficulties in using a new syringe, which, in turn, may also increase patients' sense of empowerment.
authors.affiliation: University Hospital Birmingham NHS Foundation Trust, Birmingham, UK. jenny@jennyhiley.fsnet.co.uk
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hiley
authors.forename: Dawn
authors.initials: D
authors.lastname: Homer
authors.forename: Collette
authors.initials: C
authors.lastname: Clifford
mesh_terms: D000328:Adult; D000368:Aged; D001168:Arthritis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged; D011209:Power, Psychological; D012646:Self Administration; D011795:Surveys and Questionnaires; D013594:Syringes; D016896:Treatment Outcome
chemical_list: D008727:Methotrexate