A home-based, multidisciplinary liver optimisation programme for the first 28 days after an admission for acute-on-chronic liver failure (LivR well): a study protocol for a randomised controlled trial

Table 4 Allied health referrals

Clinician	Indication for referral	Tasks
Physiotherapist	Sarcopenia^a, fall within last 6 months, FRAT^b score >11	6-min walk test (baseline and at day 28) Weekly, supervised low-intensity weight and resistance exercises
Dietitian	Sarcopenia, diabetes, alcohol dependence, MUST^c score ≥2	High protein, high energy, low salt diet plan incorporating compact nutritional supplements including a late-night snack
Social Work	Requiring long-term home support services, established disability, age >65 years	Referral for council services, aged care assessment, disability
Neuropsychiatry	Concern from the medical team regarding cognition	Neuropsychiatric assessment
Pharmacist	Polypharmacy (≥5 medications daily) and/or requiring titration of diuretic or lactulose doses	Patient and carer education, liaising with community pharmacy, organise blister pack
Addiction Medicine	Substance use disorder and alcohol pharmacotherapy	Weekly consultations, pharmacotherapy to manage substance use disorders

^aSarcopenia is defined using the European Working Group on Sarcopenia in Older People (EWGSOP) hand grip strength cut off (<27kg for males, <16kg for females) [22]
^b FRAT Falls Risk Assessment Tool [23]
^c MUST Malnutrition Universal Screening Tool [24]

ISSN: 1745-6215