Abstract
Purpose
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.
Patients and 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.
Conclusion
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.
Video abstract
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Acknowledgments
The authors want to acknowledge and thank Peter Rossing, Lone Jelstrup, Frederik Persson, and Gitte Engelund for their great contributions in the process of developing the program, executing the consultations, and drafting the paper. The authors also wish to thank Kirsten Engelhard Nielsen and Birthe Marie Jørgensen and the rest of the Clinic for support to the study and all the patients who participated in the study. The authors acknowledge Jennifer Green and Caduceus Strategies for proofreading the manuscript.
Disclosure
The authors report no conflicts of interest in this work.