4 Cardiac rehabilitation Is an 8-week, comprehensive, multidisciplinary, cardiac rehabilitation service more clinically and cost effective for managing stable angina than current clinical practice? Why this is important Cardiac rehabilitation programmes are an established treatment strategy for certain heart conditions, such as for people who have had a heart attack. However, there is no evidence to suggest that cardiac rehabilitation is clinically or cost effective for managing stable angina. Research to date has looked at short-term outcomes, such as a change in diet or exercise levels, but the effect on morbidity and mortality has not been studied. A randomised controlled trial is required to compare comprehensive cardiac rehabilitation with standard care in people with stable angina, with measures of angina severity (exercise capacity, angina frequency, use of a short-acting nitrate), and long-term morbidity and mortality as endpoints. 5 Patient self-management plans What is the clinical and cost effectiveness of a self-management plan for people with stable angina? Why this is important Stable angina is a chronic condition. Evidence suggests that addressing people's beliefs and behaviours in relation to angina may improve quality of life, and reduce morbidity and use of resources. Self-management plans could include: educating people with stable angina about the role of psychological factors in pain and pain control; and teaching people self-management skills to modify cognitions, behaviours and affective responses in order to control chest pain. These skills may include pacing of physical activities, modifying stress using cognitive reframing and problem-solving techniques, and relaxation training or mindfulness techniques. The proposed study is a randomised controlled trial in primary care that would assess the clinical and cost effectiveness of self-management plans. This research would inform future updates of key recommendations in the guideline. 