The data stemmed from two studies from the UK in a relevant population. Adequacy was rated as no or very minor concerns. Although the subfinding was explicitly supported by only two studies, it was provided in much detail. The overall assessment of confidence was moderate, having been downgraded by one increment due to serious methodological limitations. Review subfinding 4b: Ongoing relationship Healthcare professionals reported that because appointments with consultants are too short to relay all the information a patient would need regarding diagnosis and prognosis, patient education was often delegated to specialist nurses in the outpatient or community setting. Healthcare professionals suggested that education was best delivered within the ongoing relationship between the specialist nurse and patient, in particular during home visits where patients are more relaxed and able to assimilate information. In support of this some patients reported that they find it easier to communicate with nurses than to cardiologists and it was suggested that the specialist nurse environment was a good place to discuss patients condition and give information. This subfinding was based on two studies.26, 133, 313 Methodological limitations were rated moderate overall. One study had moderate limitations due to limitations in context, the role of researcher and data analysis. Another study was rated as having moderate limitations due to a lack of context, reflections on the role of the researcher, and data richness in some sections relevant to this review. Coherence was rated no or very minor concerns. Agreement between papers was very good. Relevance was rated no or very minor concerns. The relevance of the subfinding to the focus of the review was very high. The data stemmed from two studies from the UK in a relevant population. Adequacy was rated as no or very minor concerns. 