Table 3.

Prioritization of the 14 de-implementation strategies derived from the mapping process.

	Potential effectiveness To what extent do you think this intervention can achieve the desired results in the target population? 1: unlikely, 2: unlikely but deserves consideration, 3: likely, 4: very likely	Acceptability To what extent is it acceptable for key agents (PHC professionals, patients, managers, etc.) to use this intervention? 1: unacceptable, 2: not very acceptable but deserves consideration, 3: acceptable, 4: highly acceptable	Feasibility To what extent do you consider that this intervention can be implemented in the routine clinical context? 1: unfeasible, 2: unfeasible but deserves consideration, 3: feasible, 4: highly feasible
New or optimized CVR calculation tool, adding other important risk factors (e.g., family history) to the estimation and/or to help in decision-making	Very likely	Highly acceptable	Highly feasible
Alert and reminder systems (notifications, pop-ups, messages, etc.) in the Medical Record and/or in the prescription system to promote the practice according to the evidence in primary prevention of CVD	Very likely	Highly acceptable	Feasible
Alert and message reminder systems using printed material (e.g., posters, manuals, information sheets, etc.) or interactive means (emails, information capsules, newsletters, etc.) to encourage practice according to the evidence in primary prevention of CVD	Very likely	Acceptable	Feasible
Planning and organization of shared action at health center level, between medicine and nursing, for the provision of clinical intervention in promoting healthy lifestyles	Very likely	Acceptable	Feasible
Formation of a committee of experts to update or develop a corporate guidance document on primary prevention of CVD that includes: a) evidence-based clinical practice recommendations; b) unified criteria for action and responsibilities at the inter-institutional and inter-sectorial level; c) establishment of practice/performance objectives in primary prevention of CVD	Likely	Highly acceptable	Feasible
Elimination of the “asterisk” in blood test results and/or adaptation of the criteria for identification and marking of “case” (e.g., asterisk on cholesterol number >240 mg/dl)	Likely	Acceptable	Highly feasible
Training workshops on primary prevention of CVD and promotion of healthy habits, including training support resources (e.g., clinical intervention manual for promoting healthy habits)	Likely	Acceptable	Feasible
IT tools that facilitate the execution of an intervention to promote lifestyles based on evidence	Likely	Acceptable	Feasible
Corporate campaign “Giving up low-value pharmacological prescribing” promoted by Osakidetza	Likely	Acceptable	Feasible
Tools to aid clinical decision-making in the electronic prescription system, which restrict the inappropriate prescription of statins	Likely	Acceptable	Feasible
Active involvement of the patient in a shared decision-making process in CVD preventive action	Likely	Acceptable	Feasible
Inclusion of practice indicators in primary prevention of CVD in the management and evaluation tools for care performance: a) CV risk registration rate, b) rate of inappropriate prescription of statins in primary prevention in low-risk patients; c) rate of performance of actions to promote lifestyles	Likely	Acceptable	Feasible
Audit/feedback system: Periodic sending of practice or performance indicator reports in inappropriate prescription of statins and actions to promote lifestyles	Likely	Acceptable	Feasible
Edition and publication of educational and informative materials on primary prevention of CVD for patients	Unlikely	Acceptable	Feasible