title: Voiding diaries: adherence in the clinical setting.
abstract: OBJECTIVE
  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.
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, TriHealth Good Samaritan Hospital, Cincinnati, OH, 45220, USA, Rachel_Pauls@trihealth.com.
authors.forename: Rachel N
authors.initials: RN
authors.lastname: Pauls
authors.forename: Erin
authors.initials: E
authors.lastname: Hanson
authors.forename: Catrina C
authors.initials: CC
authors.lastname: Crisp
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006176:Gynecology / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D057566:Self Report / Q000706:statistics & numerical data*; D014554:Urination