Unclear MDT composition Low Risk (stable HF) - Long interventions Referral and approach to care Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: First Author / Trial name Doctor (secondary care) Nurse (secondary care) Pharma- cist Diet- ician Occupation- al therapist Social worker Physio- therapist Primary care Details HF nurse Physician Specialist HF nurse working in liaison with GP HICMan trial Peters-klimm For training primary care For training primary care Practice nurse and Physician Case management by practice nurse with 1.5 day specific extra training in case management of patients with heart failure according to a clinical practice guideline. Nurse worked with primary care physician Martensson For training primary care For training primary care Practice nurse and Physician Training provided to all practice nurses and half of physicians 3x3h sessions on pathophysiology of HF, evaluation and treatment of HF, and self-management. Upskilled practice nurse delivers self-care intervention Northstar trial Cardiologist HF nurse MDT, composition unclear Cardiologist Y Pharmacist care to encourage self-care and self-monitoring Table 102: Key activities of MDT, studies arranged by strata First Author / Trial name Meds optimisatio n Deliver DMPa Deterioration management Other Intensity (ave no. patient-professional encounters) Usual care High Risk - Short interventions Y To contact clinic, where given protocol-driven advice on increasing diuretic Carer participation in education Fixed face-to-face 3x in hospital + 2x outpatient, plus telephone Primary care, with referral to cardiology at discretion Y Contact number given min. 2 face-to-face Primary care Referral and approach to care Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: First Author / Trial name Meds optimisatio n Deliver DMPa Deterioration management Other Intensity (ave no. 