MDT clinic This category included three studies with high risk populations exposed to mid-length MDT clinic interventions. The evidence on hospitalisations was low to very low quality and inconsistent, with two studies (n=7117 and n=230) suggesting a clinically important reduction, and the third study (n=200) suggesting no clinical difference. Evidence on mortality was also low to very low quality and did not demonstrate a clear effect with the confidence interval ranging from a decrease and increase Chronic Heart Failure Referral and approach to care NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 in all-cause mortality The third study also provided evidence on quality of life and heart failure medication prescribing and adherence. Very low quality evidence suggested no clinically important difference in quality of life. The evidence on medications was moderate to very low quality and inconsistent, with evidence of a clinically important decrease in prescription of beta-blockers, but no clinical difference in prescribing of ACE inhibitors or taking prescribed medication. Most of the evidence had very wide confidence intervals around the effect estimates. Nurse-led or pharmacist-led clinic This category included 2 studies (n=25 and n=158) with high risk populations exposed to a mid-length nurse-led clinic intervention. For the outcome of hospitalisations, low to very low quality evidence suggested a clinically important reduction. Very low quality evidence suggested mortality did not demonstrate a clear effect with the confidence interval ranging from a decrease and increase in all- cause mortality The smaller study provided low quality evidence for quality of life which suggested no clinically important difference. Very low quality evidence from the same study also suggested a clinically important increase in prescribing of optimal beta-blocker doses. Evidence on all of the outcomes except for beta-blocker prescribing had very wide confidence intervals around the effect estimates. 