ISBN: 978-1-4731-3093-7 8.4.2 Review question: What is the clinical and cost effectiveness of telemonitoring and self-monitoring compared with usual care, in people with heart failure? 275 8.4.6 Recommendations and link to evidence 303 8.5 Recommendations for monitoring heart failure 308 8.5.1 Clinical review 308 8.5.2 Measuring NT-proBNP 308 9 Referral and approach to care 309 9.2 Team working in the management of heart failure 309 9.2.2 Review question: What competencies should be present in the multidisciplinary teams involved in the outpatient or community-based care of people with heart failure? 309 9.2.6 Recommendations and link to evidence 353 9.3 Transition between heart failure care settings 360 9.3.2 Review question: What are the experiences/preferences of staff and patients during transition between different heart failure care settings (including primary, secondary and community care)? 360 9.3.6 Recommendations and link to evidence 381 9.4 Information and support needs regarding diagnosis and prognosis 389 9.4.2 Review question: What are the information and support needs to be considered when communicating a diagnosis and consequent prognosis, to people with heart failure, their families and carers? 389 9.4.6 Recommendations and link to evidence 413 Chronic Heart Failure Contents NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 9.5.2 Transition between heart failure care settings 419 9.5.3 Information and support needs regarding diagnosis and prognosis 420 10 Advanced heart failure and palliative care 421 10.1 Diuretics in advanced heart failure 421 10.1.2 Review question: Which route of administration of diuretics (intravenous (IV), subcutaneous or oral) is most clinically and cost effective in people with advanced heart failure who are in the community, including patients receiving palliative care? 