{
  "abstract": "Background Alcohol use is the primary determinant of outcome for patients following a hospital admission with decompensated alcohol related cirrhosis. It is vital therefore to determine the best ways to support patients in remaining abstinent.Methods The study was conducted remotely using online software. Initially a short survey was conducted of stakeholders. These included specialists in hepatology and alcohol use disorder as well as individuals with lived experience of alcohol related cirrhosis and their carers. We asked about the facilitators and barriers to abstinence following a hospital admission. An expert Steering Group which included mmbers with lived experience examined the survey results and integrated this with other sources of evidence to produce a list of potential recommendations to optimise relapse prevention. The expert stakeholders were then asked to review each recommendation and rate their agreement with the statement ‘This recommendation should be prioritised’. Recommendations which reached consensus (>70% agreement) went through to a ranking process. Finally, ranked responses were weighted so that recommendations given a top rank received more points.Results 188 stakeholders engaged with this study, including 33 who identified as having lived experience of alcohol related cirrhosis. A wide range of themes were identified including pharmacotherapies, social circumstances, mental health and provision of services. 48 recommendations were generated by the steering panel. 37 recommendations achieved consensus from stakeholders. At the ranking stage the following 5 recommendations achieved the highest ranking scores. Four out of these 5 recommendations also appeared in the top 5 for participants with lived experience.Relapse prevention work should be presented as a routine part of the care of patients with alcohol related cirrhosis. Patients should be therefore required to opt-out rather than opt-in to relapse prevention work.Patients should be offered medications for alcohol use disorder prior to discharge.Before discharge from hospital patients should be provided with clear information about their liver disease and the risks of future alcohol use in a manner that they can understand.Community alcohol services should see patients within two weeks of discharge.Patients should be directly referred by the hospital team for relapse prevention treatment rather than having to self-refer.Abstract P15 Figure 1Conclusion Stakeholders identified that relapse prevention, including the use of pharmacotherapies, clear information, and prompt follow-up, should be prioritised as routine standard of care for all patients with alcohol related cirrhosis.",
  "authors": [
    {
      "affiliations": [
        "Cambridge University Hospitals NHS Foundation Trust,UK",
        "University of Cambridge, Cambridge, UK",
        "NIHR Cambridge Biomedical Research Centre, Cambridge, UK"
      ],
      "name": "Christopher Oldroyd"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Akwasi Mintah"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Andrea Broad"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Andrew Wellstead"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Alex Smith"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Audrey Dillon"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Barry O’Callaghan"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Veronika Boychenko"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "David Henstock"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Elizabeth Thompson"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Ewan Forrest"
    },
    {
      "affiliations": [
        "Cambridge University Hospitals NHS Foundation Trust,UK",
        "University of Cambridge, Cambridge, UK",
        "NIHR Cambridge Biomedical Research Centre, Cambridge, UK",
        "PRAC Authorship Group",
        "Institute of Liver Studies, King’s College Hospital NHS Foundation Trust, London, UK",
        "Cambridgeshire and Peterborough NHS Foundation Trust, UK",
        "Addiction Research Group, University of East Anglia, Norwich, UK",
        "The Healthcare Improvement Studies Institute, Cambridge, UK"
      ],
      "name": "Heather Lewis"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Jay Patel"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Jeff Fernadez"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Jonathan Fallowfield"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Kathryn Rothwell"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Liam Knowles"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Liz Shepherd"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Luke Tyson"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Lushen Pillay"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Lynsey Corless"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Mathis Heydtmann"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Michael Blyth"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Nicholas Bannatyne"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Naomi Kenneth"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Natasha McDonald"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Neil Rajoriya"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Nurun Tania"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Peter Hart"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Rachael Swann"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Richard Aspinall"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Richard Allen"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Ruari Lynch"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Sambit Sen"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Seonaid Anderson"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Sally Pannifex"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Stephen Barclay"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Stephen Ryder"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Stephen Hood"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Steven Masson"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Steve Rodrigues"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Tamar Avades"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Tanya Walker"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Tessa Cacciotollo"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Tim Weare"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Debs Smith"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Justin Greenwood"
    },
    {
      "affiliations": [
        "Cambridge University Hospitals NHS Foundation Trust,UK",
        "University of Cambridge, Cambridge, UK",
        "NIHR Cambridge Biomedical Research Centre, Cambridge, UK",
        "PRAC Authorship Group",
        "Institute of Liver Studies, King’s College Hospital NHS Foundation Trust, London, UK",
        "Cambridgeshire and Peterborough NHS Foundation Trust, UK",
        "Addiction Research Group, University of East Anglia, Norwich, UK",
        "The Healthcare Improvement Studies Institute, Cambridge, UK"
      ],
      "name": "Laura Tucker"
    },
    {
      "affiliations": [
        "PRAC Authorship Group"
      ],
      "name": "Farzana Kausir"
    },
    {
      "affiliations": [
        "PRAC Authorship Group",
        "Institute of Liver Studies, King’s College Hospital NHS Foundation Trust, London, UK"
      ],
      "name": "Ian Webzell"
    },
    {
      "affiliations": [
        "PRAC Authorship Group",
        "Cambridgeshire and Peterborough NHS Foundation Trust, UK"
      ],
      "name": "Jonathan Wood"
    },
    {
      "affiliations": [
        "Addiction Research Group, University of East Anglia, Norwich, UK"
      ],
      "name": "Caitlin Notley"
    },
    {
      "affiliations": [
        "Cambridge University Hospitals NHS Foundation Trust,UK",
        "NIHR Cambridge Biomedical Research Centre, Cambridge, UK"
      ],
      "name": "Michael Allison"
    },
    {
      "affiliations": [
        "University of Cambridge, Cambridge, UK",
        "The Healthcare Improvement Studies Institute, Cambridge, UK"
      ],
      "name": "Graham Martin"
    }
  ],
  "title": "P15 Priorities in relapse prevention for patients with alcohol related cirrhosis: a national expert consensus building study",
  "uid": "82827f44-ca9a-5b86-ab75-7407f652c39a"
}