Nurse-led treatment engagement interventions for persons with severe mental illnesses in community settings

Table 1 Definitions of common terms under the umbrella of treatment engagement

Term	Definition
Treatment engagement	A process of developing a collaborative and trusting relationship with individuals, which is key to delivering effective services and support[8]
Treatment adherence	The extent to which a person’s behavior-taking medication, following a diet, and executing lifestyle changes corresponds with agreed recommendations of the healthcare provider[14]
Medication compliance	The extent to which a person’s behavior matches the clinician’s recommendations[25]

Table 2 Factors influencing engagement and proposed strategies

No.	Name of the intervention/study	Factors influencing engagement	Proposed treatment engagement strategies
1	MyCHOIS[31], (United States). Setting: Hospital-based	Substance abuse, lack of access to treatment, lack of engagement with the therapist, and need for long-term treatment	MyCHOIS is a web-based shared decision-making model. MyCHOIS supports clinical decision-making and quality improvement
2	Building therapeutic alliance in home-based treatment[32], (United states). Setting: Community based	Relationship with therapist, traits of the therapist, insight, family support	Experiential interactions and skill-building exercises spread over 12 sessions to improve engagement
3	Just Do You[34], (United States). Persons with schizophrenia, BPAD and anxiety disorders. Setting: Community-based recovery and rehabilitation programme	Beliefs on the benefits of medication, credibility and trust in providers, emotional reactions to treatment, stigma, social norms, access to treatment and hope	Just Do You-a meta-intervention of two 90-minute modules. Encompassing expressive arts, technology-based narratives, psychoeducation, and principles of motivational interviewing
4	Customised adherence enhancement-long-acting injectables-CAE-L[39], (North Carolina). Setting: Community Mental Health Centers	Lack of knowledge on illness and treatment, use of substances, medication side effects, lack of access to specialized care, and being symptomatic	Improving medication-taking habits/routines, communication, and modified motivational interviewing techniques with long-acting injectables
5	Customised adherence enhancement-long-acting injectables-CAE-L[40], (Tanzania). Setting: Hospital based	Inconsistent medication routines, side effects of medications, financial constraints, lack of qualified mental professionals, lack of care access	Psychoeducation, modified motivational enhancement therapy, optimizes the management of side effects and incorporates medication routines to one’s lifestyle
6	Care at doorstep[45], (India). Setting: Community-based	Lack of knowledge, lack of family support, being symptomatic, stigma, explanatory model, financial and accessibility to treatment, medication side effects	Care at doorstep: Three home visits were made by the team and provided. Medications, also offered brief psychoeducation and counselling
7	Medication adherence therapy[59], (India). Setting: Tertiary care mental hospital	Lack of knowledge on illness and treatment, forgetfulness, lack of motivation, side effects, duration of illness, and financial issues	Four in-person sessions on medication compliance, namely psychoeducation on BPAD, motivational session, overcoming practical barriers, use of drug cards and phone call reminders once every 15 days for three months
8	Nurse-led intervention to improve adherence[60], (India). Setting: Tertiary care mental hospital	Lack of knowledge, forgetfulness	Psycho-education, an explanation of individualistic behavior tailoring or memory cues, a demonstration of preparation and use of pill boxes, and the distribution of information booklet
9	Integrative one-on-one intervention[55], (Israel). Setting: Tertiary care mental hospital	Forgetfulness, negative attitude to medications, financial issues, actively symptomatic, lack of insight, stigma, side effects of medication, lack of family support	Integrative one-one intervention strategies for handling side effects in liaison with a psychiatrist, psychoeducation, motivational interviewing and cognitive behavioral strategy. An average of six sessions, each 20-40 minutes over two weeks
10	Telephone intervention by trained nurses[56], (United States). Setting: Community mental health center	Beliefs and values regarding treatment, confidence and ability to overcome adherence barriers, lack of family support, social isolation, stigma, cognitive deficits, side effects of medication, logistics	Telephone intervention: Psychoeducation, problem-solving technique
11	Adherence therapy based on motivational interviewing[48], (Hong Kong, China). Setting: Community-based	Attitude and behavior regarding illness and treatment, lack of knowledge, stigma, lack of insight, symptom severity	Motivational, cognitive, insight-inducing and behavioral interventions conducted over eight sessions
12	Compliance therapy[58], (London, United Kingdom). Setting: Community-based	Side effects of medications, being symptomatic	Compliance therapy, medication management, interventions for medication side effects

MyCHOIS: My Collaborative Health Outcomes Information System; BPAD: Bipolar affective disorder; CAE-L: Customised adherence enhancement-long.