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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

1
Medical School, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
2
NHS Tayside Ninewells Hospital, Dundee DD1 9SY, UK
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(11), 1926; https://doi.org/10.3390/ijerph16111926
Received: 11 April 2019 / Revised: 27 May 2019 / Accepted: 28 May 2019 / Published: 31 May 2019
(This article belongs to the Special Issue Global Advances in Telehealth Practice)
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Abstract

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. View Full-Text
Keywords: Clinical Decision Support Systems; Opioid Analgesics; Focus Groups; Pilot Projects; Palliative Care Clinical Decision Support Systems; Opioid Analgesics; Focus Groups; Pilot Projects; Palliative Care
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Flint, R.; Buchanan, D.; Jamieson, S.; Cuschieri, A.; Botros, S.; Forbes, J.; George, J. 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. Int. J. Environ. Res. Public Health 2019, 16, 1926.

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