Conclusion
SECONDARY
The described educational intervention for telephone triage nurses did not influence the out-of-hours attendance for RTIs or list-holding GPs’ attendance. Changing a population’s health service attendance is complicated, and the intervention’s pragmatic design with a lack of control on the proportion of participating nurses, and its limited scope, may be reasons for the missing effect on the primary and secondary outcomes. Future studies on educational interventions should include a process evaluation, be planned for a longer period, and involve both health planning councils and leaders at different levels, as well as GPs and nurses in out-of-hours cooperatives. Furthermore, a need exists to explore the perspective of callers with RTIs who are advised to wait-and-watch or seek their list-holding GPs to reduce non-urgent use of the out-of-hours service.