title: An open-label study to assess changes in efficacy and satisfaction with migraine care when patients have access to multiple sumatriptan succinate formulations.
abstract: BACKGROUND
  Because a patient's migraines often differ in duration, intensity, and accompanying symptoms, as well as the conditions and circumstances at the time of the headache, the mode for treatment also may change.
  
  
  OBJECTIVE
  The goal of this study was to determine whether migraine management is improved by providing 3 formulations of sumatriptan succinate to patients, together with education to assist them in selecting the most appropriate formulation for specific attacks.
  
  
  METHODS
  This was an open-label study conducted in 3 family practice settings. Patients were recruited who had at least a 1-year history of migraine meeting International Headache Society criteria and experienced 2 to 6 attacks per month within the previous 3 months. Patients received instructions on oral, intranasal, and subcutaneous (SC) sumatriptan and were provided with all 3 formulations to treat 6 headaches. Migraine features, formulation used, reason for selecting specific formulation, migraine symptom relief, and use of follow-up doses were recorded in diaries. At follow-up, patients completed a questionnaire assessing satisfaction with access to multiple formulations.
  
  
  RESULTS
  Of the 33 enrolled patients (26 women, 7 men; mean age, 38.5 years [range, 23-54 years]), 25 (75.8%) completed all visits. Of 149 headaches treated, 39 (26.2%) were mild at onset, 70 (47.0%) were moderate, and 40 (26.8%) were severe. Eighty (53.7%) headaches were treated with tablets, 35 (23.5%) with nasal spray, and 34 (22.8%) with SC injection. Primary reasons for selecting specific formulations included "fewer side effects" for tablets, "convenience" for nasal spray, and "quick onset of action" for SC injection. Twenty-one (84.0%) patients reported being either very satisfied or satisfied with their ability to manage their headaches. Physicians reported that 18 of 24 (75.0%) patients had an improved attitude toward managing their headaches. All formulations were well tolerated. Eight (32.0%) patients reported adverse events, the 2 most common being chest pressure and fatigue.
  
  
  CONCLUSIONS
  The patients in this study reported greater satisfaction with migraine management when given access to multiple sumatriptan formulations and education regarding their appropriate use.
authors.affiliation: South Austin Medical Clinic, Austin, Texas, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Weidmann
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Unger
authors.forename: Stephen
authors.initials: S
authors.lastname: Blair
authors.forename: Christopher
authors.initials: C
authors.lastname: Friesen
authors.forename: Carolyn
authors.initials: C
authors.lastname: Hart
authors.forename: Roger
authors.initials: R
authors.lastname: Cady
mesh_terms: D000281:Administration, Intranasal; D000284:Administration, Oral; D000328:Adult; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D020325:Migraine with Aura / Q000188:drug therapy*; D020326:Migraine without Aura / Q000188:drug therapy*; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D012646:Self Administration; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018170:Sumatriptan / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
chemical_list: D017366:Serotonin Receptor Agonists; D018170:Sumatriptan