Voiding diaries: adherence in the clinical setting.

INTRODUCTION AND HYPOTHESIS: The objective was to document adherence with 24-h voiding diaries in the evaluation of routine urogynecology patients.
METHODS: This was a cross-sectional study of 200 patients presenting for initial urogynecological consultation. All were mailed a standardized packet prior to their visit, including a 24-h voiding diary. Upon arrival, subjects were asked to complete a brief survey. Eight questions targeted those that completed the diary ("completers"); 3 targeted those that did not ("noncompleters"). "Completers" were further sub-classified based on survey responses. Those recording each void immediately were termed "appropriate completers." Others were considered "inappropriate completers." Demographics and other data were obtained from the medical records.
RESULTS: Eleven women were excluded for recording more than 24 h of data. Of the 189 remaining subjects, 157 (83 %) completed the diary. Many "noncompleters" were unaware of the diary (54 %). Others chose not to complete it, most commonly citing "don't think it applies" (25 %). On univariate analysis "completers" were older (p = 0.049), with more complaints of mixed incontinence (p = 0.001). Fifty-four percent of "completers" were deemed "appropriate." "Appropriate completers" voided more frequently (p = 0.024) than "inappropriate completers." After multivariate analyses, however, only lower parity and unemployed status were associated with appropriate diary completion. Reassuringly, the majority, 77 %, believed that the diary responses were reflective of their typical behavior, and voiding frequency on the diary correlated with self-report during their medical history (rs = 0.483, p < 0.001).
CONCLUSIONS: Although compliance with voiding diaries is reasonably high in the office setting, adherence to instructions is less optimal. Strategies to improve ease of use could benefit future patient care.