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This programme found adding the intervention to usual care for people with heart failure with reduced ejection fraction improved quality of life at 12 months compared with usual care alone.

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Hasnain M Dalal 1,2,*, Rod S Taylor 1,3, Jennifer Wingham 1, Colin J Greaves 4, Kate Jolly 5, Chim C Lang 6, Russell C Davis 7, Karen M Smith 8, Patrick J Doherty 9, Jackie Miles 10, Robin van Lingen 11, Fiona C Warren 1, Susannah Sadler 1, Charles Abraham 1,12, Nicky Britten 1, Julia Frost 1, Melvyn Hillsdon 13, Sally Singh 14, Christopher Hayward 15, Victoria Eyre 16, Kevin Paul 1,2

1 Institute of Health Research, University of Exeter Medical School, Exeter, UK
2 Research and Development, Royal Cornwall Hospitals NHS Trust, Truro, UK
3 Professor of Population, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
4 School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
5 Institute of Applied Health Research, University of Birmingham, Birmingham, UK
6 School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
7 Cardiology Department, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
8 Cardiac Rehabilitation Office, Ninewells Hospital, Dundee, UK
9 Department of Health Sciences, University of York, York, UK
10 Research and Development, Aneurin Bevan University Health Board, St Woolos Hospital, Newport, UK
11 Duchy Hospital, Truro, UK
12 School of Psychological Sciences, University of Melbourne, Victoria, VIC, Australia
13 Sport and Health Sciences, University of Exeter, Exeter, UK
14 Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK
15 Peninsula Clinical Trials Unit, University of Plymouth, Plymouth, UK
16 Re:Cognition Health, London, UK
* Corresponding author Email: h.dalal@nhs.net

Declared competing interests of authors: Hasnain M Dalal is an ordinary council member of the British Association of Cardiovascular Prevention and Rehabilitation. Rod S Taylor is a member of the Health Technology Assessment (HTA) National Stakeholder Advisory Group. Kate Jolly reports grants from the National Institute for Health Research (NIHR) Public Health Research, NIHR Research for Patient Benefit, NIHR Global Health Research Group, NIHR HTA and NIHR Collaborations for Leadership in Applied Health Research and Care programme outside the submitted work. Russell C Davis reports personal fees from Novartis International AG (Basel, Switzerland), Servier Laboratories (Suresnes, France) and Bristol Myers Squibb (New York, NY, USA) outside the submitted work. Charles Abraham, Rod S Taylor, Colin J Greaves and Nicky Britten are also supported by the NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula at the Royal Devon and Exeter NHS Foundation Trust; Kate Jolly by CLAHRC West Midlands; and Sally Singh by CLAHRC East Midlands. For Charles Abraham and Nicky Britten, this work was partially funded by the UK NIHR PenCLAHRC. Rod S Taylor, Sally Singh and Hasnain M Dalal report receiving research funding for trials of ExCR during the course of this updated review. All authors report grants from NIHR during the course of the trial.

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