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Table 3 Examples of barriers to change and interventions tailored to overcome them*

From: Identifying barriers and tailoring interventions to improve the management of urinary tract infections and sore throat: a pragmatic study using qualitative methods

Barrier to change

Interventions selected

Barrier adequately addressed?

Loss of income with telephone consultations

Increased fee for telephone consultations

Yes, although we are not sure that the increase in fee was large enough

Changing routines from ordinary visits to increased use of telephone consultations is a complex process

Plan and support for the practices to discuss existing routines and make changes, patient information

No. We did not have the means to actively support the practices discussing and changing their routines

Fear of overlooking serious disease with telephone consultations, delegating responsibility to GP assistants, and not using lab tests

Computer-based decision support with structured questions including check list with warning symptoms

Partially. Most practices needed more active support in using the computer-based system with confidence

Patients want and expect testing for urinary tract infection and sore throat and treatment for sore throat

Patient information, both in written format and computer-based, linked to the decision support system

Partially, this intervention depends on GPs giving patient information. Supplying leaflets is not enough

Not enough time to read information about the project and study the guidelines

Brief versions of guidelines, computer-based reminders, incentives for participation

Partially. We were not able to help practices prioritise time for studying and discussion

  1. *The barriers are similar for urinary tract infection and sore throat, if not specifically stated.