Electronic Diaries: Exploring Cross-Cultural Preferences and Acceptability

Abstract

Introduction: The literature supports the use of electronic diaries (e-diaries) in a variety of populations, including different disease and age groups. However, there has been little discussion of cross-cultural preferences. The aim of this study was to compare acceptability of paper and electronic diaries to collect symptom data from patients with benign prostatic hyperplasia (BPH) in the United States and Slovakia. Methods: Participants were 28 US and 20 Slovak men aged 49–83 years with moderate-to-severe BPH. All were randomly assigned to complete a paper or electronic urinary symptom diary for 7 consecutive days, then complete the alternate version for another 7 days. Participants' experiences with the diaries were assessed via ease of use and preference questions and patient interview. Site issues were assessed via tracking of technical problems and investigator feedback. Results: The US men preferred the electronic version, whereas men in Slovakia had equal preference between the formats. Most men in both countries felt they could continue using the e-diary for another 2 weeks and still provide accurate information. Technical issues at the Slovakian site included incompatibility with power supplies, loss of battery power, and problems downloading data. Conclusion: The use of e-diaries is feasible with BPH populations, although this may vary by country. When including in clinical trials patients who are less familiar with technology, careful consideration should be given to diary design, training, and technical issues in that country that may have an impact on the data collection process.