Predictors of participant compliance with ecological momentary assessment among individuals with chronic pain who are using cannabis and opioids

Background: Cannabis may be an alternative or adjunct to opioid therapy for chronic pain. However, there are limited data on patterns of opioid medication and medical cannabis use. The current study investigated the feasibility of using Ecological Momentary Assessment (EMA) to assess patterns of prescription opioids and medical cannabis among individuals experiencing chronic pain.

Method: The study included 133 participants recruited online. Participants were 42.6 (SD = 13.9) years old on average and the majority were men (57.9 %) and Non-Hispanic White (63.2 %). Participants completed a baseline assessment, followed by 30 days of EMA data collection with four randomly prompted past-hour surveys and one daily diary per day, and a follow-up survey that assessed perceived EMA burden. Simple and multivariable linear regression models were estimated to investigate participant predictors of the proportion of EMA surveys completed (past-hour surveys and daily diaries in separate models).

Results: Compliance rates for EMA prompts were 89.7 % for daily diaries and 63.3 % for past-hour surveys. In multivariable regression, participants holding a graduate degree completed a lower proportion of daily diaries (b = −0.109, SE = 0.052, p < .05) and past-hour surveys (b = −0.148, SE = 0.071, p < .05), compared to those with less than a 4-year degree. Participants completing a higher proportion of daily diaries reported greater ease of use at follow-up (b = 0.050, SE = 0.022, p < .05) and those completing a higher proportion of past-hour surveys desired higher rewards (b = 0.066, SE = 0.033, p < .05).

Conclusions: Study results confirm the feasibility of using EMA methods to assess patterns of prescription opioids and medical cannabis among individuals experiencing chronic pain.