Table 3.

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

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

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