The Safer Prescription of Opioids Tool (SPOT): A Novel Clinical Decision Support Digital Health Platform for Opioid Conversion in Palliative and End of Life Care-A Single-Centre Pilot Study

Opioid errors are a leading cause of patient harm. Active failures in opioid dose conversion can contribute to error. Conversion is complex and is currently performed manually using tables of approximate equivalence. Apps that offer opioid dose double-checking are available but there are concerns ab...

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Bibliographic Details
Published in:International journal of environmental research and public health 2019-05, Vol.16 (11), p.1926
Main Authors: Flint, Roger, Buchanan, Deans, Jamieson, Scott, Cuschieri, Alfred, Botros, Shady, Forbes, Joanna, George, Jacob
Format: Article
Language:English
Subjects:
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - therapeutic use
Communication
Conversion
Decision Support Systems, Clinical - organization & administration
Decision Support Systems, Clinical - standards
Dose-Response Relationship, Drug
Drug dosages
End of life
End users
Health care
Humans
Medical errors
Mobile Applications
Narcotics
Opioids
Pain
Palliative care
Palliative Care - organization & administration
Palliative Care - standards
Patient safety
Pilot Projects
Polls & surveys
Population studies
Practice Patterns, Physicians
Prospective Studies
Questionnaires
Smartphones
Studies
Terminal Care - organization & administration
Terminal Care - standards
Usability
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Summary:Opioid errors are a leading cause of patient harm. Active failures in opioid dose conversion can contribute to error. Conversion is complex and is currently performed manually using tables of approximate equivalence. Apps that offer opioid dose double-checking are available but there are concerns about their accuracy and clinical validation. This study evaluated a novel opioid dose conversion app, The Safer Prescription of Opioids Tool (SPOT), a CE-marked Class I medical device, as a clinician decision support (CDS) platform. This single-centre prospective clinical utility pilot study followed a mixed methods design. Prescribers completed an initial survey exploring their current opioid prescribing practice. Thereafter prescribers used SPOT for opioid dosage conversions in parallel to their usual clinical practice, then evaluated SPOT through a survey and focus group. SPOT matched the Gold Standard result in 258 of 268 (96.3%) calculations. The 10 instances (3.7%) when SPOT did not match were due to a rounding error. Users had a statistically significant increase in confidence in prescribing opioids after using SPOT. Focus group feedback highlighted benefits in Quality Improvement and Safety when using SPOT. SPOT is a safe, reliable and validated CDS that has potential to reduce harms from opioid dosing errors.
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph16111926