The Safer Prescription of Opioids Tool (SPOT): A Novel Clinical Decision Support Digital Health plat-form for opioid conversion in Palliative and End of Life care. A single-centre pilot study

Roger Flint, Deans Buchanan, Scott Jamieson, Alfred Cuschieri, Shady Botros, Joanna Forbes, Jacob George (Lead / Corresponding author)

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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.

Original languageEnglish
Article number1926
Pages (from-to)1-8
Number of pages8
JournalInternational Journal of Environmental Research and Public Health
Issue number11
Publication statusPublished - 31 May 2019



  • Clinical Decision Support Systems
  • Focus Groups
  • Opioid Analgesics
  • Palliative Care
  • Pilot Projects

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