ORAL-AGENTS IN THE MANAGEMENT OF URTICARIA - PATIENT PERCEPTION OF EFFECTIVENESS AND LEVEL OF SATISFACTION WITH TREATMENT

OBJECTIVE: Orally administered diphenhydramine, famotidine, and cromol yn sodium were compared for their abilities to alleviate symptoms of a cute urticaria. DESIGN AND SETTING: This was a prospective, randomized , blind study, implemented in the emergency departments (EDs) of two t eaching hospitals, each with an annual average of 40 000 ED patient vi sits. Patient perception of the effectiveness of treatment was assesse d using a visual analog scale. PATIENTS: 33 adult patients presenting to the EDs were entered into the study over a one-year period. Of thes e, 8 were lost to follow-up and 5 were noncompliant with medications a nd not included in data analysis. Twenty adult patients, aged 19-78 ye ars, completed the five-day study: 7 received diphenhydramine, 6 recei ved famotidine, and 7 received cromolyn sodium. RESULTS: Patients rece iving diphenhydramine reponed the greatest satisfaction with treatment : 86 percent (6/7) indicated they would use the medication again. Fift y percent (3/6) in the famotidine group and 43 percent (3/7) in the cr omolyn sodium group rated the treatment as worth using again. Patients receiving famotidine reported the greatest occurrence of adverse effe cts (50 percent, 3/6); die lowest incidence of such effects was seen i n the cromolyn sodium group (14 percent, 1/7). Patients receiving diph enhydramine reported adverse effects at a rate of 43 percent (3/7). CO NCLUSIONS: Our results suggest that patients receiving diphenhydramine are more satisfied with their treatment than are patients receiving f amotidine or cromolyn sodium.