An Overview of Factors Associated with Adherence and Dropout to Ecological Momentary Assessments in Depression

The use of technology-based Ecological Momentary Assessments (EMAs) allows to repeatedly assess patients during daily life, in naturalistic settings and in precise moments of the day. To date, EMAs have been broadly adopted for the investigation of Major Depressive Disorder (MDD). Nevertheless, adherence still represents a clinical challenge, as depressed patients may be less prone to regularly complete daily reports. Through a systematic narrative review, we qualitatively investigated factors affecting adherence and dropout of MDD patients to EMA protocols. The mean adherence rate across studies was generally encouraging (mean: 80.66%, SD 11.71%), and was higher in studies collecting self-reports by means of smartphones, prompting patients less than 8 times per day and using a prefixed sampling method. Dropouts were mainly related to technical problems or under-threshold number of collected answers, often occurring in studies collecting data by means of Personal Digital Assistants (PDAs). The implications of these results are discussed