Low to very low quality evidence on quality of life reported in three of the studies (n=220, n=210, n=197) suggested a clinically important benefit. Moderate to low quality evidence on prescribing of beta-blockers from two studies (n=153, n=210) suggested a clinically important benefit. Evidence on ACE inhibitor prescribing was inconsistent, with two studies (n=210, n=154, moderate to low quality) suggesting a clinically important benefit and a third (n=153, low quality) suggesting no clinical difference. Chronic Heart Failure Referral and approach to care NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 Nurse-led or pharmacist-led clinic This category included two studies (n=679 and n=208) with high risk populations exposed to a long nurse-led clinic intervention. Evidence for hospitalisations was of moderate to low quality and showed no clinical difference in the former study but a clinical benefit for the latter. The evidence for mortality was of low quality and did not demonstrate a clear effect with the confidence interval ranging from a decrease and increase in all-cause mortality. One study (n=208) also reported quality of life and medication prescription. The evidence for quality of life was of low quality and showed no clinical difference. Evidence for prescribed ACE-inhibitors and beta-blockers were of low to very low quality and showed a clinically important reduction for both outcomes. Case management One study (n=186) with a high risk population undergoing a long case-management programme was included in this category. Low to very low quality evidence suggested a clinically important reduction in hospitalisations, deaths and prescription of beta-blockers. Moderate quality evidence suggested no difference in the prescription of ACE-inhibitors or ARB. Quality of life was not reported. Low risk, Short No studies were identified in these categories. Low risk, Mid-length No studies were identified in these categories. 