Opioid conversion ratios used in palliative care: Is there an Australian consensus?

Syrmis, W., Good, P., Wootton, J. and Spurling, G. (2014) Opioid conversion ratios used in palliative care: Is there an Australian consensus?. Internal Medicine Journal, 44 5: 483-489. doi:10.1111/imj.12401

Author Syrmis, W.
Good, P.
Wootton, J.
Spurling, G.
Title Opioid conversion ratios used in palliative care: Is there an Australian consensus?
Journal name Internal Medicine Journal   Check publisher's open access policy
ISSN 1444-0903
Publication date 2014-01-01
Year available 2014
Sub-type Article (original research)
DOI 10.1111/imj.12401
Open Access Status Not yet assessed
Volume 44
Issue 5
Start page 483
End page 489
Total pages 7
Place of publication Richmond, VIC Australia
Publisher Blackwell Publishing
Language eng
Subject 2724 Internal Medicine
Abstract Background: Opioid switching or rotation is reported to be a common practice in palliative care. Published tables of opioid conversion ratios have been found to vary in their recommendations, potentially leading to significant differences in clinical practice. Aims: To identify common practices in the calculation of opioid equianalgesia by specialist palliative medicine practitioners and trainees. Method: An anonymous, cross-sectional, online survey completed by 85 Australian palliative care specialists or advanced trainees. Questions focused on conversion ratios used in switching between oral and parenteral opioid doses; conversion ratios used when switching from other opioids to oral morphine; and practice of commencing methadone. Results: The majority of respondents calculated equianalgesic doses for morphine, oxycodone and hydromorphone using the same conversion ratios. Methadone was used almost equally as either the sole opioid or as a 'co-opioid'. The majority surveyed converted slow-release hydromorphone differently to the manufacturer's recommendations. Conclusion: Further discussion among Australian palliative care specialist organisations is recommended in order to produce uniform conversion guidelines to improve consistency and safety in the prescribing of opioids.
Keyword Analgesia
Opioid analgesic
Palliative care
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Discipline of General Practice Publications
Official 2015 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 4 times in Thomson Reuters Web of Science Article | Citations
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