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OPIOID CONVERSION CHART : INTRODUCTION OF A USER-FRIENDLY VERSION
  1. Mariam George1,
  2. Clare Wilkins1,
  3. Idaliza Garner2 and
  4. Barbara Powell1
  1. 1 Palliative medicine, LOROS Hospice, Leicester, UK
  2. 2 Research Support, LOROS Hospice, Leicester, UK

    Abstract

    Background Opioid dose conversion is an integral part of palliative care services. Though several such conversion charts exist, they generally lack simplicity and uniformity in their ease of use across the spectrum of palliative care professionals.

    Aim To develop a simple, easily understandable and user-friendly opiate conversion chart.

    Method Using a common conversion chart template, we modified diagrammatic representations to include simple, clear-cut formulae. The chart represents a ‘sun’ with 9 ‘sunbeams’. The oral morphine (mg/day) is the ‘sun’ at the centre of the chart, encouraging the conversion between different opiates to start with morphine equivalent doses. All conversions complied with Palliative Care Formulary (3rd edition), Leicestershire/Northamptonshire/Rutland cancer network ‘Guide to prescribing for patients with Advanced malignancy’ and the Oxford handbook of pain management guidelines. Laminated pocket-sized versions were produced to make it portable to enable rapid and easy dose conversions by the bedside. Feedback questionnaires were distributed among healthcare professionals in different roles working across hospice, hospital and community.

    Results Twenty-two feedback forms were returned. 95% (21/22) of professionals found it useful, with 68% (15/22) utilising it ‘often’/‘always'. All those who used it confirmed that it was a practical, simple and convenient tool. The chart empowered hospice-based nurses and community clinical nurse specialists to feel confident about the accuracy of dose conversions. It was also useful as a teaching aid, enabled appropriate dosage of transdermal opioids and served as a benchmark for provision of advice to other services. Specialist doctors and trainee doctors in other specialties who have rotated through hospice posts found it useful. Indirect positive feedback was reflected by an increase in the use of the chart across clinical professionals in Leicestershire.

    Conclusion This adapted user-friendly conversion chart has the potential to simplify and make uniform the use of opiates across the palliative care community.

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