Oral agents in the management of urticaria: patient perception of effectiveness and level of satisfaction with treatment.

OBJECTIVE

Orally administered diphenhydramine, famotidine, and cromolyn sodium were compared for their abilities to alleviate symptoms of acute urticaria.

DESIGN AND SETTING

This was a prospective, randomized, blind study, implemented in the emergency departments (EDs) of two teaching hospitals, each with an annual average of 40,000 ED patient visits. Patient perception of the effectiveness of treatment was assessed using a visual analog scale.

PATIENTS

33 adult patients presenting to the EDs were entered into the study over a one-year period. Of these, 8 were lost to follow-up and 5 were noncompliant with medications and not included in data analysis. Twenty adult patients, aged 19-78 years, completed the five-day study: 7 received diphenhydramine, 6 received famotidine, and 7 received cromolyn sodium.

RESULTS

Patients receiving diphenhydramine reported the greatest satisfaction with treatment: 86 percent (6/7) indicated they would use the medication again. Fifty percent (3/6) in the famotidine group and 43 percent (3/7) in the cromolyn sodium group rated the treatment as worth using again. Patients receiving famotidine reported the greatest occurrence of adverse effects (50 percent, 3/6); the lowest incidence of such effects was seen in the cromolyn sodium group (14 percent, 1/7). Patients receiving diphenhydramine reported adverse effects at a rate of 43 percent (3/7).

CONCLUSIONS

Our results suggest that patients receiving diphenhydramine are more satisfied with their treatment than are patients receiving famotidine or cromolyn sodium.