This study aims to reduce potentially inappropriate prescribing (PIP) of statins and foster healthy lifestyle promotion in cardiovascular disease (CVD) primary prevention in low-risk patients. To this end, we will compare the effectiveness and feasibility of several de-implementation strategies developed following the structured design process of the Behaviour Change Wheel targeting key determinants of the clinical decision-making process in CVD prevention.

A cluster randomised implementation trial, with an additional control group, will be launched, involving family physicians (FPs) from 13 Integrated Healthcare Organisations (IHOs) of Osakidetza-Basque Health Service with non-zero incidence rates of PIP of statins in 2021. All FPs will be exposed to a non-reflective decision assistance strategy based on reminders and decision support tools. Additionally, FPs from two of the IHOs will be randomly assigned to one of two increasingly intensive de-implementation strategies: adding a decision information strategy based on knowledge dissemination and a reflective decision structure strategy through audit/feedback. The target population comprises women aged 45–74 years and men aged 40–74 years with moderately elevated cholesterol levels but no diagnosed CVD and low cardiovascular risk (REGICOR

The study was approved by the Basque Country Clinical Research Ethics Committee and was registered in ClinicalTrials.gov (NCT04022850). Results will be disseminated in scientific peer-reviewed journals.

NCT04022850.

Frailty is widely acknowledged as a multidimensional construct encompassing physical, psychological and social aspects. However, the lack of consensus in defining and operationalising psychological frailty challenges the holistic approach to frailty advocated by health professionals. Consequently, there is a need to develop a comprehensive definition of psychological frailty based on contributions made by experts in the field, primarily existing frailty assessment tools. This scoping review will aim to identify the key psychological variables that are considered in frailty assessment tools used with older adults as well as to analyse how these psychological variables have been operationalised.

The study will be conducted in accordance with recommendations from several methodological frameworks for scoping reviews and will be reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews statement guidelines. A systematic literature search will be performed in the CINAHL, MEDLINE, PsycInfo, Scopus and Web of Science databases, supplemented by a search in Google Scholar and reference lists. The focus will be on studies that describe the development of multicomponent frailty assessment tools including at least one psychological variable. Study selection and data extraction will be independently conducted by three reviewers working in pairs. Data will be presented in tabular form, and the data will be analysed using qualitative content analysis.

This study does not require ethical approval since it is based on secondary data analysis. The findings of the review will be disseminated through publication in a peer-reviewed scientific journal and will be presented at conferences and seminars.

The scoping review was registered in Open Science Framework on 29 March 2022 (https://osf.io/bn24y).