The reality on opioid analgesics abuse (both prescription and non-prescription) in the US is shocking. Statistics from the CDC show that opioid abuse has risen to epidemic proportions. Every day, 44 people die of a prescription opioid overdose in the US and over 7,000 are treated in emergency rooms. Over 2 million people in the US are currently addicted to prescription opioids. This makes opioid abuse an everyday reality for ERs and primary care providers in the US and worldwide. One of the biggest challenges primary care providers have to face is dealing with the complex conversions of one opioid analgesic to the next, which could have catastrophic results with either opioid withdrawal or overdose, if not done properly.
Mobile apps that work as opioid converters could be a solution. But, the biggest problem with these apps is their inconsistency. Some offer a great deal of information, but have a poor implementation, while others do the opposite.
One of the best opioid conversion apps available is Opioid Calculator, developed by the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists (FPM ANZCA).
This app calculates total oral morphine equivalent daily dose for combinations of opioids, and this calculation is based on the standard from Opioid Dose Equivalence – Calculation of Oral Morphine Equivalent Daily Dose (oMEDD) table, which is developed and endorsed by the Faculty’s Education Committee to provide consistency in converting combinations of opioids.
The lack of a single, accepted table of analgesic equivalence made opioid calculation complicated, difficult, and prone to miscalculations, misinterpretation and compounding inaccuracies. The biggest advantage of The Opioid Calculator app was bringing in accuracy and consistency in the process of calculating a single opioid equianalgesic dose for an individual on multiple medications, which would otherwise remain complex, time-consuming, and susceptible to potential errors.
The app can be used to guide decisions regarding the patient's total ongoing opioid use, even in the context of multiple and changing medication regimes, as well as decisions of dosing when changing from one opioid to another.
Upon starting the app, you'll see the home page, which offers the basic information about the app on the Home button, useful reference links you can reach by tapping Info button. From this screen, you can also share the app with a friend.
Once you've read all info, tap on the arrow at the top to start the calculator. You'll be first guided through the sort of tour, which will explain to you how to use the calculator, i.e. how to access opioids, how to change values, etc.
You'll notice an explanation for an interesting and unique feature - an evidenced-based "traffic light" warning system. The developers of the app have adopted this "traffic light" warning system to warn against the potential harm of escalation of opioid doses and provide a new level of clinical caution. Basically, there are three colors that indicate the levels of risk.
GREEN color indicates low risk of dose-related harm if used in accordance with clinical guidelines.
AMBER color indicates caution because there is an increased risk of dose-related harm.
Finally, RED color alerts that there's a high risk of harm due to predictable adverse effects, dependence or inadvertent overdose.
We found this feature very useful because it shows warnings about risk levels in a clear and direct manner.
Once the tour is finished, you'll be redirected to Preference page to select from the list of opioids of your interest. You can leave all checked, or check opioids based on nation preference (AU, NZ or US), or hospital or custom preferences.
Upon choosing preferences, the calculator screen opens allowing you to enter the doses of medications, which are listed in a table, based on your preferences from the previous screen. A simple interface allows you to enter doses using plus and minus signs. You can also enter doses, using your keyboard. Once you have entered the current dose tap on Conver to proceed to Opioid Target where you can select the drug for equianalgesic dosing. You'll get recommended doses, both written and visual, in color scheme of "traffic light" warning system.
The Opioid Calculator app is a valuable tool for all involved in the management of patients on opioids. It is based on scientific evidence and provides information in a user-friendly format.
Benefit: This Opioid Calculator app is designed for all medical professionals, medical students, and nurses engaged in the care of patients with persistent pain.