Therapeutic area · PainUpdated September 28, 2026

EDC for chronic pain trials, built around the daily diary

Pain is measured every day, not every visit. Capture runs daily pain diaries on participants' phones, tracks compliance before it becomes missing data, and keeps rescue medication, function and global impression on the same schedule.

  • Daily NRS or VAS diary
  • Rescue medication captured
  • Compliance on the dashboard

Free sandbox · No credit card · 21 CFR Part 11 aligned

Evening pain diary

Day 18 · Treatment week 2

Average pain over the last 24 hours

0 no pain · 10 worst pain imaginable

012345678910

Did you take rescue medication today?

NoYes

How many tablets?

2
Completed in the evening window

What matters in pain trials

  • The primary endpoint is usually pain intensity from a daily diary, averaged over a week, on an 11-point numeric rating scale or a visual analogue scale.
  • A baseline week before randomisation establishes eligibility and a stable starting point.
  • Consensus recommendations for chronic pain trials cover six core outcome domains: pain, physical functioning, emotional functioning, participant ratings of improvement, symptoms and adverse events, and participant disposition.
  • Rescue medication use affects pain scores and should be captured on the same diary.
  • Diary compliance is the endpoint's weak point. Reminders, windows and early warnings protect it.

The endpoint

Why pain trials depend on diary compliance

A weekly average built from seven daily ratings is a robust measure. The same average built from two ratings is not, and a participant who stops completing the diary mid-trial creates missing data exactly where the treatment effect is measured. That is why pain trials usually set a minimum number of completed diary days per week for the weekly average to count.

Paper diaries made this worse: entries completed in the car park before a visit ("parking lot compliance") look complete but are not daily. Electronic diaries with completion windows solve that by accepting entries only in the window they refer to. Capture's windows can be soft, hard, warning-only or auto-close, and reminders go out when an entry is due, the next day and before the window closes.

Baseline week and eligibility

Most protocols require a minimum average baseline pain and a minimum number of completed baseline diary days before randomisation. Running the baseline diary in the same system as the rest of the study means those rules are checked on the same data that feeds the endpoint.

Responders, not just means

Alongside mean change, pain trials commonly report the proportion of participants with at least 30% and at least 50% reductions in pain. Those analyses need a complete baseline and complete weekly averages, which is another reason compliance matters.

Diary compliance · Treatment week 2

Participants

58

≥ 5 of 7 days

52

At risk

6

Site 01 · compliant this week19/20
Site 02 · compliant this week17/19
Site 03 · compliant this week16/19

3 participants missed 3 or more days

Act before a week is lost

Outcome domains

Core outcome domains and how to capture them

DomainTypical measureHow it runs in Capture
PainDaily NRS or VAS, weekly averageRecurring ePRO diary with completion window
Physical functioningDisease-specific function scale or pain interference itemsVisit-based ePRO or site form
Emotional functioningDepression and anxiety questionnairesVisit-based ePRO, e.g. PHQ-9 and GAD-7
Global improvementPatient global impression of change (7-point)Single-choice ePRO at follow-up visits
Symptoms and adverse eventsAE log, specific symptom questionsAE log form with minimum dataset
DispositionCompletion, withdrawal reasons, rescue useSubject status and structured reasons

Rescue medication

Capture rescue use on the day it happens

If participants take rescue analgesics, pain on those days reflects the rescue drug as well as the study treatment. Asking about rescue use in the same evening diary as pain ratings gives the analysis what it needs to handle it according to the estimand, without relying on recall at the next visit.

  • Rescue yes or no, with number of doses.
  • Skip logic shows dose questions only when relevant.
  • Same timestamped entry as the pain rating.
1

When due

18:00

Your evening diary is open

2

Next day

18:00

Reminder: your diary is still open

3

Final notice

21:30

Last chance before the window closes

Quiet hours

22:00 to 08:00 in the participant's time zone

Stops

As soon as the task is completed

Indications

Condition-specific instruments on the same schedule

Osteoarthritis, low back pain, neuropathic pain and fibromyalgia trials each add their own function or impact measures to the daily diary. Build each as its own form, place it at the visits the protocol specifies, and record licence details where the instrument requires one.

  • Licensed instruments with licence tracking on the form.
  • Clinician-rated and participant-reported forms in one casebook.
  • Visit windows applied the same way at every site.
Schedule of assessments · Chronic low back pain
AssessmentScrRun-inW1W2W4W8W12
Daily pain NRSDDDDDD
Rescue medicationDDDDDD
Disability questionnaire
PGIC
PHQ-9

D = daily evening diary

Complete a pain diary on your own phone tonight

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Design

Placebo response and how data practices can reduce noise

Analgesic trials are notorious for large placebo responses. Some of that is expectation and regression to the mean, which design must address. But some is measurement noise that better data practices can reduce: participants who rate pain inconsistently, baseline scores inflated to meet entry criteria, and missed diary days filled in from memory.

Three practices help. Train participants on the rating scale at screening, so "5" means the same thing throughout the study. Use the baseline diary, not a single clinic rating, to assess eligibility, which filters out people whose pain varies too much to show an effect. And enforce completion windows so every score is recorded on the day it describes. All three rely on the diary being in the same system as the rest of the study, with its compliance visible to the team.

Opioids and abuse-deterrence studies

Trials involving opioids or other drugs with abuse potential often add assessments of misuse, withdrawal and drug liking, and tighter drug accountability. Those are site forms and logs like any others; the IMP inventory and accountability features keep dispensing and returns reconciled.

Study build

Pain study build checklist

Scale and wording fixed

NRS or VAS, anchors and recall period identical in every entry.

Baseline rules written

Minimum average pain and minimum completed diary days before randomisation.

Weekly average rule

Minimum days per week for a valid average, pre-specified.

Rescue medication on the diary

Yes or no with doses, same entry as the rating.

Core domains covered

Function, emotional functioning, global impression, AEs and disposition.

Compliance review routine

Weekly review of at-risk participants on the dashboard.

FAQ

Questions teams ask before they switch

Something not covered here? Ask us directly.

What is the typical primary endpoint in chronic pain trials?

Change from baseline in average daily pain intensity, usually from a daily 0 to 10 numeric rating scale averaged over a week.

Why use electronic pain diaries?

Completion windows ensure entries are made on the day they refer to, reminders improve compliance, and sites can see missed days in real time.

How should rescue medication be recorded?

On the same daily diary as the pain rating, with whether rescue was taken and how much.

What are the core outcome domains for chronic pain trials?

Pain, physical functioning, emotional functioning, participant ratings of improvement, symptoms and adverse events, and participant disposition.

Do participants need an app?

No. Diaries open in the phone browser from a secure link.

Can I try it free?

Yes. The free sandbox includes ePRO diaries and every other feature.

Protect the diary, protect the endpoint

Daily diaries with windows, reminders and compliance tracking. Free sandbox.

Build your pain study free