OBJECTIVES: Understanding the real-world effectiveness of triptans in migraine, a trial was conducted using patient-reported outcomes to evaluate the benefit of triptan therapy before and after switching to eletriptan 40mg. METHODS: Physicians enrolled migraineurs into an open-label treatment-satisfaction study using web-based data collection technology. Patients' demographic information, migraine experience, utilization of health care resources and level of satisfaction with prior migraine therapy (both prescription and over-the-counter treatments) were evaluated separately for headache pain relief, speed of pain relief and ability to return to daily activities. Patients were then switched to eletripan 40mg and their level of satisfaction across each outcome domain was measured for three migraine attacks. RESULTS: Of the 2778 patients enrolled (87.1% female; mean age, 37.4 years; 83.6% employed; averaged 5.5 attacks per month lasting a mean duration of 11 hours; 49.9% high health care utilizers [≥1 headache-related outpatient and/or emergency room visit per month]), 2303 (82.9%) treated at least one migraine attack with eletriptan 40mg. Patient-reported satisfaction (4 or 5 on a 5-point scale) with eletriptan 40mg was 68.8%, 57.2% and 62.8% for headache pain relief, speed of pain relief and ability to return to daily activities, respectively, and was significantly greater when compared with satisfaction with prior therapy (triptan and non-triptan): 29.8%, 22.1% and 21.7%, respectively (p<0.001). Seventy percent of high health care utilizers achieved satisfactory-to-completely-satisfactory pain relief on eletriptan 40mg. Employed patients were significantly more satisfied (64.2%) than unemployed patients (56%) with eletriptan 40mg (p<0.01). CONCLUSION: Increased level of patient satisfaction on eletriptan when compared with prior therapy indicates a significant unmet need for optimized treatment of acute migraine in this patient population. Further research is required to determine whether increased satisfaction is associated with decreased health care utilization. Such real-world effectiveness data might be useful in formulary decision making and health care benefit design.