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We also found the consultation context important in determining intervention practices.
If so, our study shows that our GERD-education program supersedes patient information given within the usual consultation context.
Therefore the impact of the innovation must be studied within the consultation context before deploying that innovation in practice or recommending a formal clinical trial.
Hence, we will report on the fidelity of the intervention, content of the consultation, context for the use of the agenda and any impact on the consultation.
Whilst studies have reported longer face-to-face consultations for patients with mental health related issues in primary care [ 13, 14, 25] this is the first time that this has been reported in the telephone consultation context.
In the framework of the ongoing French GENEPSO ("Gene Etude Prospective Sein Ovaire") project managed by the French Cancer Genetic Network, BRCA1/2 mutation carriers were recruited in a routine consultation context at cancer genetic clinics between 2000 and 2006.
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In 38 out of 40 consultations, context factors prompted application of the context-specific rating protocol.
Participant accounts are retrospective and limited to that which is remembered and reported; however, recall accuracy and completeness may be enhanced by playing back the video-recorded consultation within the interview context: 'video stimulated recall' (VSR).
Our results show that in routine GP consultations, several context factors can be identified that - as a single factor or synergistically - clarify why GPs deviate from the recommended communication behaviour.
As explanations for why they had these core cognitions, patients mentioned consultation-specific factors (GPs' actions during the consultation) and context-specific factors (patients' pre-existing cognitions based on experiences that had occurred before the consultation, e.g. regarding their GP, the doctor-patient relationship and prior events) (Table 3).
This paper looks at aspects of doctor patient communication and focuses on how prescribing decisions fit into the consultation within the context of the use (and non-use) of a technological clinical decision support system (CDSS) in the UK.
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