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Optimising the validity and completion of adherence diaries: a multiple case study and randomised crossover trial
Rachael Frost1, Doreen McClurg2, Marian Brady2
1NMAHP-RU, Glasgow Caledonian University, Glasgow, UK. rachael.frost@ucl.ac.uk.
Trials
|October 12, 2016
Summary
Home-based rehabilitation trials often use diaries to measure adherence, but their validity varies. This study found that while diaries are valid at a group level, individual data lacks accuracy, questioning their use in predicting outcomes.
Area of Science:
- Rehabilitation Medicine
- Health Services Research
- Clinical Trial Methodology
Background:
- Diaries are commonly used to measure adherence in home-based rehabilitation trials.
- However, diary completion and validity vary significantly across studies.
Purpose of the Study:
- To develop a theoretical basis for understanding adherence diary variation.
- To create an optimized adherence diary.
- To evaluate the validity of the optimized diary.
Main Methods:
- A multiple case study approach was used to develop a diary optimization model.
- An optimized diary was compared to a non-optimized diary in a randomized crossover trial with healthy adults aged 60+ undertaking a walking program.
- Adherence was measured using diaries and an Activpal accelerometer.
Main Results:
- Both optimized and non-optimized diaries showed similar validity, reliability, and acceptability.
- Group-level duration adherence data demonstrated close agreement with accelerometer data.
- Individual-level data exhibited high variation, with wide limits of agreement for duration and frequency adherence.
Conclusions:
- Group-level adherence data from diaries appear valid for home-based rehabilitation trials.
- Individual diary data lack sufficient validity for predicting functional outcomes.
- Diary design variations likely have minimal impact on adherence measurement validity.
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