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.
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.
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.
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.
The findings highlight the importance of provider factors including beliefs and attitudes, team location (urban versus rural) and consultation context in determining rates of intervention for lifestyle risk factors, along with patients' socio-economic status.
In clinical practice, primary care health professionals show considerable variation in assessing lifestyle behavioural risk factors [ 32], but again treatment choices are generally influenced by the health professionals' beliefs and attitudes, and also by geographic location, consultation context and the patient's socio-economic status.
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.
