Table 3 Data analysis process

1. CM identified and coded conversation sequences related to gout in the transcripts. CM then reviewed the video-recordings to confirm and enrich the analysis. A note was made of any important contextual non-verbal communication from either party e.g. nodding of the head, smiling, sighing, listening attentively, examining the patient, turning away from the patient.

2. Initial coding included:

 - how gout was introduced into a consultation and by whom

 - the location within the consultation

 - the importance of the condition from the patient perspective

 - diagnosis and treatment of the condition

 - emphasis placed on biochemical test results and dietary and lifestyle advice

3. Themes and sub-themes were identified from the data. Initial interpretations of the clinical relevance and importance of the themes derived were debated and discussed between CM, a pharmacist and experienced qualitative researcher, and AD, the general practitioner member of the project team.

4. LM and MS, researchers with experience in linguistics, contributed to a second round of discussion and interpretation. Examples of refinements at this point include:

 - “Gout as an incidental part of the consultation” and “Impact of gout for patients” being combined as sub-themes of the over-arching theme “The importance of gout”

 - A linguistic interpretative viewpoint to the differences observed around lifestyle and medicines

 - Acknowledgement of the importance and possible ambiguity of ‘semi-verbal’ communication (e.g. the use of “mm” by participants)

5. Disagreements were resolved by consensus.

6. All authors reviewed and agreed the final themes and interpretation