Variability among Online Opioid Conversion Calculators Performing Common Palliative Care Conversions.

Introduction: Online opioid conversion calculators (OOCCs) are commonly used to aid conversion between opioids to overcome tolerance, reduce adverse effects, or challenges related to administration. The purpose of this study was to describe and characterize variability among OOCC used by health care...

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Published in:Journal of Palliative Medicine Vol. 25; no. 4; pp. 549 - 556
Main Authors: Costantino, Ryan C., Barlow, Ashley, Gressler, Laura E., Zarzabal, Lee Ann, Tao, Dennis, McPherson, Mary Lynn
Format: research tables/charts Journal Article
Published: Mary Ann Liebert, Inc. Apr2022
Online Access:View this record in EBSCOhost
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      dt: Apr2022
      vid: 25
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      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        10.1089/jpm.2021.0041
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        atl: Variability among Online Opioid Conversion Calculators Performing Common Palliative Care Conversions.
      aug:
        au:
          Costantino, Ryan C.
          Barlow, Ashley
          Gressler, Laura E.
          Zarzabal, Lee Ann
          Tao, Dennis
          McPherson, Mary Lynn
        affil: Enterprise Intelligence and Data Solutions, Defense Healthcare Management Systems, San Antonio, Texas, USA.
      sug:
        subj:
          Palliative Care
          Health Personnel
          Analgesics, Opioid
          Hospices
          Human
          Quantitative Studies
          Surveys
          Sentiment Analysis
          Pain Management
      ab: Introduction: Online opioid conversion calculators (OOCCs) are commonly used to aid conversion between opioids to overcome tolerance, reduce adverse effects, or challenges related to administration. The purpose of this study was to describe and characterize variability among OOCC used by health care practitioners when converting common opioids and doses encountered in the hospice and palliative care setting. Methods: We collected 58 quantitative surveys and performed sentiment analysis on 62 qualitative responses from adult learners primarily practicing in the palliative care setting and enrolled in an online palliative care Master of Science program through the University of Maryland, Baltimore, who were asked to perform opioid conversion calculations using realistic patient cases. Results: OOCC have substantial variability leading to a wide range of outputs, which may put patients at risk for opioid-related harm. Assessing participant sentiment toward OOCC showed most participants held a "Negative Sentiment" toward these calculators after the activity. Conclusion: Overall, findings reveal that given the same information, clinicians can come to widely different opioid doses and these differences can be amplified by OOCC. These differences can be particularly dangerous given the higher opioid doses commonly used in the palliative care setting. Considering the significant harm that can arise from an error when converting between opioids, clinicians should avoid the routine use of OOCC in real-world patient care settings. If an OOCC is used, organizations should endorse a specific calculator, provide training and education about the algorithm that supports the calculations, and encourage clinicians to use it only after their own manual calculation, which should be documented in the medical record.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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