The SPOT platform is a new medical device. A clinician-led, clinically validated, clinician decision support tool, SPOT is designed to reduce opioid prescribing error.
In the final stages of development, the platform allows users to access up to date prescribing information and calculate drug dosages through their smartphones, including iOS and Android.
SPOT will aid clinicians to prescribe adequate analgesia, improving patient outcomes, and thereby lower healthcare costs by reducing admissions due to dosage error.
All prescriptions using SPOT are recorded, improving communication within and between multidisciplinary teams. SPOT can be used for clinical governance purposes, improving accountability for prescribing, and provides evidence for revalidation.
SPOT is CE marked, and distributed to end users using a SAAS model. The need for SPOT is pressing.
The EQUIP study highlighted that 43.8% of prescriptions contained an error 1. All grades of prescriber made errors, and the highest error rate was in Foundation Year 2 doctors2. The causes are multifactorial, but root cause analysis identified common themes, include a lack of knowledge of their prescription, pressure of work, and inadequate knowledge of relevant prescribing rules3.
NHS England conducted a study of admissions due to Adverse Drug Reactions (ADRs) in two large hospitals in Merseyside. Over six months, 1225 ADR related admissions were observed. 72% of these were judged to be avoidable, including medication errors. The median bed stay in these cases was 8 days, accounting for 4% of capacity. The projected cost of such admissions to the NHS was estimated at £466m4.
SPOT aims to revolutionise the way that opioids are prescribed, reducing error, cost to the NHS and safeguarding patients.
As a junior doctor, I know this acutely. Out of hours, two weeks after starting work in my first rotation as an FY1 in General Medicine, I was asked to switch a dying patient on nasogastric opiates to a syringe driver. Her nasogastric route was compromised. It was not a familiar procedure, and I asked for help.
I contacted the registrar, who was busy with acutely unwell patients. Once I found the correct guideline, I manually converted the patient’s nasogastric opiate intake to a subcutaneous syringe driver. This took me a considerable amount of time, and all the while the patient was not receiving her pain relief.
In the end, I did not have the confidence to prescribe the opiates, as I was unsure that I had made the correct conversion using pen and paper. I called the registrar to double-check the dosages.
It was a sobering lesson, and I was determined that no other junior doctor or nurse prescriber should be put in the same position. At that time, I decided to create a program to ensure that junior staff can double-check their opiate calculations.
Alfred Cuschieri is Professor of Surgery at the Scuola Superiore Sant’Anna in Pisa and Chief Scientific Advisor to the Institute of Medical Science and Technology (IMSaT). Previously he was Professor and Head of Department of Surgery and Molecular Oncology at Ninewells Hospital and Medical School, University of Dundee. His research interests include minimal access therapy, endoscopic surgery, technology and micro-robotics, ergonomics, nanotechnology and nanoscience and virtual/augmented reality systems for skills training. Alfred Cuschieri is the European Editor-in-Chief of Surgical Endoscopy and serves on the Editorial Board of 10 other peer review journals.
Academic Lead and Director of Research and Development for NHS Tayside
Dr Jacob George, MB ChB, MRCP, MD is a senior clinical lecturer, consultant physician in clinical pharmacology and acute medicine. He is a trials expert and the Tayside representative of the Scottish Medicines Consortium. To date, Dr George has attracted in excess of £1.2m research funding.
Consultant in Palliative Medicine and Palliative Care Clinical Lead for NHS Tayside
Dr Deans Buchanan, MB ChB, BSc (Hons), M.D., FRCP. Clinical lead for Palliative care research in NHS Tayside and consultant in Palliative care medicine. He has published widely and the co-director for the Dundee University MPH programme. Dr Buchanan is a civic co-sponsor of the project.
Steering Group Primary Care Lead
Dr Scott Jamieson MBChB MRCGP DRCOG DFSRH DPD. GP Partner in Kirriemuir and OOH GP in Dundee. He represents GPs locally at RCGP Scottish Council and locally sits on Medicines Advisory Group and the Therapeutics Committee.
BSc MSc BN RN Project Manager
and Senior Research Nurse
Joanna has experience in acute, high dependency and intensive care nursing. She has been a member of the nurse team at the Clinical Research Centre since 2008 and the facility’s Project Manager since 2015.
Founder and Medical Doctor
Founder. Doctor Flint Ltd is led by Dr Roger Flint, MB ChB, BSc. (Hons), MSc., a medical doctor with a background in Public Health. His Masters degree involved the interrogation of large general practice data sets and producing novel search strategies. His work has been published in the Primary care respiratory journal.