Clinical problem1 ________________________________________________________________________________________________________________

What should clinicians be doing (based on best evidence)2 _______________________________________________________________________________

What are clinicians currently doing (wrong)3 __________________________________________________________________________________________

Practice environment	Specific barrier or facilitator	Possible interventions	Comments (including need for more information, if any)	
Disincentives (or incentives) including financial, workload	

			
Organisational constraints including equipment, personnel, bureaucratic 	

			
External expectations including patient expectations, legal liability	

			
Work climate (e.g. morale, accountability, organisational expectations) 	

			
1. e.g. hypertension  2. e.g. Thiazide should be the first line drug.  3. e.g. Thiazides are under-used. 

Professional environment	Specific barrier or facilitator	Possible interventions	Comments (including need for more information, if any)	
Routines or habits (e.g. from professional training)	

			
Local standards and reluctance to deviate from those	

			
Local or national opinion leaders	

			
Advocacy by drug companies or others	

			

Knowledge, skills and attitudes	Specific barrier or facilitator	Possible interventions	Comments (including need for more information, if any)	
Lack of knowledge or skills (i.e. unaware of appropriate care)	

			
Clinical confidence to act (e.g. to diagnose or start a treatment)	

			
Attitudes towards condition (e.g compulsion or lack of compulsion to act)	

			
Attitudes towards patients (e.g. empathy)