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Variability among Online Opioid Conversion Calculators Performing Common Palliative Care Conversions.
Ryan C Costantino1,2,3, Ashley Barlow4, Laura E Gressler3
1Enterprise Intelligence and Data Solutions, Defense Healthcare Management Systems, San Antonio, Texas, USA.
Online opioid conversion calculators (OOCCs) show significant variability, potentially harming patients. Clinicians should avoid routine OOCC use and verify calculations manually, especially in palliative care.
Area of Science:
- Palliative Care
- Pain Management
- Medical Informatics
Background:
- Online opioid conversion calculators (OOCCs) are widely used in healthcare.
- They assist in managing opioid tolerance, side effects, and administration challenges.
Purpose of the Study:
- To describe and characterize the variability of OOCCs.
- To assess their use in hospice and palliative care settings.
Main Methods:
- Collected 58 quantitative surveys and analyzed 62 qualitative responses.
- Participants performed opioid conversion calculations using realistic patient cases.
Main Results:
- OOCCs exhibit substantial variability, leading to diverse outputs and potential patient risk.
- Most participants reported negative sentiment towards OOCCs after the activity.
- Clinician-derived opioid doses varied significantly, amplified by OOCCs.
Conclusions:
- Significant variability in OOCCs can lead to dangerous dosing errors, particularly in palliative care.
- Clinicians should avoid routine OOCC use and perform manual calculations.
- If OOCCs are used, organizations should endorse specific calculators, provide training, and require manual verification.
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