The committee agreed that the lack of information regarding the usual care arm of the included studies reduced their ability to be confident that the effects observed in the intervention arm were not being overestimated by less than Chronic Heart Failure Monitoring NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 Recommendations No recommendation Research recommendation No research recommendation standard care within the usual care group. Furthermore, the committee did not feel that they could be confident that the usual care prescribed in the studies was representative of current UK practice. Structured telephone support The clinical evidence for STS in people with chronic heart failure suggested that there was a clinically important reduction in mortality for those who have had a recent hospital admission and those who were recruited within the community. There was no clinical effect of STS on hospitalisations in people who had recently been admitted. While in people recruited within the community, STS showed a clinically important reduction in hospitalisations. The differences between the interventions used in each study also made it difficult to interpret the effectiveness of STS overall. For example there was a significant degree of variability in the intensity (i.e. daily calls compared to monthly calls), and the focus of the STS (i.e. clinical monitoring of heart failure signs and symptoms with clinical support provided compared to self- management education). The effect of STS on QoL was variable depending on the measurement scale used e.g. the SF-36 or MLWHF. A number of the QoL outcomes were also associated with a large degree of uncertainty due to wide confidence intervals surrounding the effect estimate again making it difficult for the committee to interpret the true clinical effect. 