Stratification: Length of intervention delivered in the study three months (short) > three months, six months (mid) > six months (long) Where study length varied due to recruitment dates, average length was used. Where study length varied due to the needs of the patient, the shortest duration of protocol was used. Outcomes CRITICAL - All-cause mortality (Time to event) - Quality of life (Continuous) - Unplanned hospitalisation (Count rate) IMPORTANT - Medicine optimization and adherence - Dying in preferred place of death (for palliative care patients) - Adverse events hypotension, hyperkalaemia, and renal function - Patient and carer experience Study design Systematic Review of RCTs RCTs (including cluster randomised) Comments Studies that were concerned with the care and discharge management of patients hospitalised for decompensation of heart failure come under the remit of the acute heart failure guidelines. Therefore, when patients were recruited in hospital, at least one face-to-face meeting was required after the patient had been discharged for the study to be included. There is no minimum duration of intervention, but the last outcome measure must be at least three months after the intervention begins. Studies that were concerned with interventions covered elsewhere in the guideline were excluded, as these will have separate guidance. Usual care was considered likely to differ significantly from the UK / NHS standard if the study was carried out in a country outside the OECD or in the United States. 9.2.3 Clinical evidence A search was conducted for randomised trials comparing management involving multidisciplinary team care (MDT) with usual care without an MDT. Twenty two studies were included in the review . Interventions were heterogeneous, and were categorised into 4 main strands based on the definitions in a recent Cochrane report 326 Chronic Heart Failure Referral and approach to care NICE 2018. 