Patient non-compliance with paper diaries
Open accessAbstract
Doctors often ask patients to recall recent health experiences, such as pain, fatigue, and quality of life. 1 Research has shown, however, that recall is unreliable and rife with inaccuracies and biases. 2 Recognition of recall's shortcomings has led to the use of diaries, which are intended to capture experiences close to the time of occurrence, thus limiting recall bias and producing more accurate data.3 The rationale for using diaries would be undermined if patients failed to complete diaries according to protocol.In this study we used a newly developed paper diary that could objectively record when patients made diary entries in order to compare patients' reported and actual compliance with diary keeping.For comparison, we also used an electronic diary designed to enhance compliance in order to assess what compliance rates might be achieved.
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In the only study that objectively measured dietary self-monitoring adherence, there was little concordance between self-reported and electronically documented data.
“The electronic data were compared to the self-reported record of self-monitoring and revealed that there was little concordance between the self-reported and electronically documented data (35, 37).”
From Self-monitoring in weight loss: a systematic review of the literature (2011) · cites this paper as [37]
The Methods and results report a large discrepancy between reported paper-diary compliance (90%) and compliance documented by electronic sensors (11%). However, this was a study of pain diaries in adults with chronic pain, not dietary self-monitoring; the paper also does not establish that it was the only study to measure adherence objectively. (LLM, conf=0.87)
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- Authors
- Stone, A. A., Shiffman, S., Schwartz, J. E., Broderick, J. E., & Hufford, M. R.
- Affiliations
- Stony Brook University (US)
- Corresponding author
- Stone, Arthur A
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2002-05-18
- Volume
- 324
- Issue
- 7347
- Pages
- 1193-1194
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC111114
- OpenAlex
- W2135374245
- Semantic Scholar
- fa7362653cde1df677f2bce06810aebf6ca6b177
- Cited by
- 810
- References
- 10
- Citations by year
- 2026: 12 · 2025: 17 · 2024: 19 · 2023: 18 · 2022: 36 · 2021: 25 · 2020: 40 · 2019: 27 · 2018: 43 · 2017: 26 · 2016: 34 · 2015: 43 · 2014: 44 · 2013: 41 · 2012: 38
- FWCI
- 135.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (R01CA085819, CA-85819)
- Topics
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- medication adherence, paper diaries, electronic diary, recall bias, patient-reported outcomes, self-monitoring
- MeSH terms
- Adult, Humans, Medical Records, Intractable Pain, Treatment Refusal
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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