Generated Narrative: PlanDefinition

StructureDefinition Work Group: cds

url: http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-08

identifier: id: #urn:oid:2.16.840.1.113883.4.642.11.10, id: cdc-opioid-guidance (use: OFFICIAL)

version: 0.1.0

name: Cdcopioid08

title: CDC Opioid Prescribing Guideline Recommendation #8

type: ECA Rule (PlanDefinitionType#eca-rule)

status: draft

date: 2018-03-19

publisher: HL7 International / Clinical Decision Support

contact:

description: Clinicians should incorporate into the management plan strategies to mitigate risk, including considering offering naloxone when factors that increase risk for opioid overdose, such as history of overdose, history of substance use disorder, higher opioid dosages (≥50 MME/day), or concurrent benzodiazepine use, are present.

UseContexts

jurisdiction: United States of America (ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code#US)

purpose: CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.

usage: Before starting and periodically during continuation of opioid therapy, clinicians should evaluate risk factors for opioid-related harms.

copyright: © CDC 2016+.

topic: Opioid Prescribing ()

author: Kensaku Kawamoto, MD, PhD, MHS: , Bryn Rhodes: , Floyd Eisenberg, MD, MPH: , Robert McClure, MD, MPH:

relatedArtifact

type: documentation

display: CDC guideline for prescribing opioids for chronic pain

document

relatedArtifact

type: documentation

display: MME Conversion Tables

document

library: http://example.org/fhir/Library/opioidcds-recommendation-08

action

title: Existing patient exhibits risk factors for opioid-related harms.

description: Checking if the trigger prescription meets the inclusion criteria for recommendation #8 workflow.

documentation

type: documentation

document

Triggers

-	Type	Name
*	named-event	medication-prescribe

condition

kind: applicability

Expressions

-	Description	Language	Expression
*	Check whether the existing patient exhibits risk factors for opioid-related harms, such as concurrent use with benzodiazepine, a history of substance abuse, and/or an average MME greater than 50 mg/day.	text/cql	Inclusion Criteria

groupingBehavior: visual-group

selectionBehavior: exactly-one

dynamicValue

path: action.description

Expressions

-	Language	Expression
*	text/cql	Get Detail

dynamicValue

path: action.title

Expressions

-	Language	Expression
*	text/cql	Get Summary

dynamicValue

path: action.extension

Expressions

-	Language	Expression
*	text/cql	Get Indicator

Actions

-	Description
*	Will offer Naloxone instead
*	Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo
*	N/A - see comment; snooze 3 mo