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

International Journal of Environmental Research and Public Health

Joanna Forbes¹  Jacob George¹  Roger Flint¹  Alfred Cuschieri¹  Deans Buchanan²  Shady Botros²  Scott Jamieson² 

[1] Medical School, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK;NHS Tayside Ninewells Hospital, Dundee DD1 9SY, UK;

关键词: Clinical Decision Support Systems;    Opioid Analgesics;    Focus Groups;    Pilot Projects;    Palliative Care;   

DOI  :  10.3390/ijerph16111926

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown