Compliance with ecological momentary assessment protocols in substance users: a meta-analysis

Abstract

Background and Aims: While there are considerable benefits to Ecological Momentary Assessment (EMA), poor compliance with assessment protocols has been identified as a limitation, particularly in substance users. Our aim was to identify the pooled compliance rate of EMA studies in substance users and examine variables that may influence compliance with EMA protocols, such as the length and frequency of assessments. Design: A meta-analysis and meta-regression of all possible studies (randomized controlled trials and longitudinal) which incorporated EMA protocols, examining substance use. Setting: Studies took place from 1998 to 2017, in numerous countries world-wide. Participants: One hundred and twenty-six studies were identified, contributing a total of 19 431 participants (52.32% male, mean age = 28.86). Measurements: Compliance data, the proportion of responses to the study protocol, were extracted from each study alongside prompt frequency, total length of assessment period, substance use population and device used to administer EMA prompts. Findings: The pooled compliance rate across all studies was 75.06% [95% confidence interval (CI) = 72.37%, 77.65%]. There was no evidence that compliance rates were significantly associated with prompt frequency [Q(3) = 7.35, P = 0.061], length of assessment period [Q(2) = 2.40, P = 0.301], substance type [Q(3) = 6.30, P = 0.098] or device administration [Q(4) = 4.28, P = 0.369]. However, dependent samples (69.80%) had lower compliance rates than non-dependent samples [76.02%; Q(1) = 4.13, P = 0.042]. Conclusions: The pooled compliance rate for Ecological Momentary Assessment studies in substance-using populations from 1998 to 2017 was lower than the recommended rate of 80%, and was not associated with frequency or duration of assessments.