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Int J Clin Pharm (2011) 33:2532 DOI 10.1007/s11096-010-9464-z
RESEARCH ARTICLE
Dose calculation in opioid rotation: electronic calculator vs. manual calculation
Herbert Plagge Wilhelm Ruppen
Norman Ott Thomas Fabbro Delia Bornand
Stefanie Deuster
Received: 2 May 2010 / Accepted: 23 November 2010 / Published online: 13 January 2011 Springer Science+Business Media B.V. 2010
Abstract Objective To generate, validate and establish a web-based individualised opioid conversion calculator at the University Hospital Basel and to analyse its value and signicance. Setting A 700-bed university hospital. Method Published data were screened by a Medline search using the keywords: opioid, rotation, switching, potency and dose ratio. Based on this data, the criteria for the conversion calculator were dened. A prospective process validation was performed prior to the approval. Five months after the introduction of the tool, an online survey was performed in order to evaluate its acceptance by users. In the last step, a manual calculation using a written table was compared with the calculator in a cross-over trial with 72 participants in order to assess the ndings of the survey. Results The opioid conversion calculator could be generated for 24 combinations of 6 opioids for 5 different routes of administration. The validation of the calculator was performed successfully without discovering any major or critical defects. The proportion of correct answers increased from 68% using the table to 81% using the calculator (P \ 0.001), the median time necessary to answer the ten questions was 8.9 min using the table and 4.8 min using the calculator. Conclusion A web-based opioid
conversion calculator was planned, generated, validated and established at the hospital. Based on the results of the online survey and the results of our cross-over trial we conclude that the tool saves time compared to manual calculation and may contribute to patient safety by avoiding calculation errors. With this tool we contribute to the optimisation of processes in hospital and patient safety.
Keywords Chronic pain Opioid rotation Equianalgesic
dose ratio (EDR) Opioid conversion calculator Manual
calculation Calculation error
Impact of ndings on practice
The use of an opioid conversion calculator facilitates the conversion of opioids and saves time compared to manual calculation.
We could demonstrate the superiority of our opioid conversion calculator over a dosing table by reducing the...