ISBN: Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with primary care Risk difference with MDTc (95% CI) from: 0 to 105. 2 years due to risk of bias 0 (IQR -1 to 0) control group Prescribed ACE-I 920 MODERATEc due to risk of bias (from 44 fewer to 35 more) Prescribed beta-blocker 920 MODERATEc due to risk of bias (from 44 fewer to 44 more) Adverse - serum creatinine increase >50% during follow-up VERY LOWa, c due to risk of bias, imprecision 35 cases renal failure per 2 fewer renal failure per 1000 (from 20 fewer to 35 more) Adverse - hyperkalaemia (potassium > 5.0mmol/l) at follow-up LOWa, c due to risk of bias, imprecision (from 45 fewer to 6 more) Adverse - hypotension 723 VERY LOWa, c due to risk of bias, imprecision (from 4 fewer to 42 more) (a) Downgraded by one increment as confidence interval crosses one MID or two increments as confidence interval crosses both MID. (b) Precision cannot be formally assessed, but interquartile range suggests small confidence interval. (c) Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias. 9.2.3.2.7 Low risk, Long, Nurse-led or pharmacist-led clinic Table 122: Clinical Evidence Summary: Agvall 2013: Long Nurse-led clinic (MDTcm) vs Primary care (1 control), >6 months for low-risk HFREF Outcomes No of Participants Quality of the evidence Relative effect Anticipated absolute effects Referral and approach to care Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. 