title: Empowerment, motivation, and medical adherence (EMMA): the feasibility of a program for patient-centered consultations to support medication adherence and blood glucose control in adults with type 2 diabetes.
abstract: OBJECTIVE
  To explore the feasibility of a research-based program for patient-centered consultations to improve medical adherence and blood glucose control in patients with type 2 diabetes.
  
  
  METHODS
  The patient-centered empowerment, motivation, and medical adherence (EMMA) consultation program consisted of three individual consultations and one phone call with a single health care professional (HCP). Nineteen patients with type 2 diabetes completed the feasibility study. Feasibility was assessed by a questionnaire-based interview with patients 2 months after the final consultation and interviews with HCPs. Patient participation was measured by 10-second event coding based on digital recordings and observations of the consultations.
  
  
  RESULTS
  HCPs reported that EMMA supported patient-centered consultations by facilitating dialogue, reflection, and patient activity. Patients reported that they experienced valuable learning during the consultations, felt understood, and listened to and felt a trusting relationship with HCPs. Consultations became more person-specific, which helped patients and HCPs to discover inadequate diabetes self-management through shared decision-making. Compared with routine consultations, HCPs talked less and patients talked more. Seven of ten dialogue tools were used by all patients. It was difficult to complete the EMMA consultations within the scheduled time.
  
  
  CONCLUSIONS
  The EMMA program was feasible, usable, and acceptable to patients and HCPs. The use of tools elicited patients' perspectives and facilitated patient participation and shared decision-making.
authors.affiliation: Patient Education Research, Steno Diabetes Center, Gentofte, Denmark.
authors.forename: Annemarie Reinhardt
authors.initials: AR
authors.lastname: Varming
authors.affiliation: Patient Education Research, Steno Diabetes Center, Gentofte, Denmark.
authors.forename: Ulla Møller
authors.initials: UM
authors.lastname: Hansen
authors.affiliation: Complications Research, Steno Diabetes Center, Gentofte, Denmark.
authors.forename: Gudbjörg
authors.initials: G
authors.lastname: Andrésdóttir
authors.affiliation: Patient Education Research, Steno Diabetes Center, Gentofte, Denmark.
authors.forename: Gitte Reventlov
authors.initials: GR
authors.lastname: Husted
authors.affiliation: Patient Education Research, Steno Diabetes Center, Gentofte, Denmark.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Willaing
keywords: adherence; dialogue; health education; participation; self-management; type 2 diabetes