Opioid CDS Recommendation 8 ECA Rule (id = "opioidcds-08")

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  display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border:
       1px solid #8da1b4; border-radius: 5px; line-height: 60%: 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.Clinical Focus (Details: http://terminology.hl7.org/CodeSystem/usage-context-type
             code focus = 'Clinical Focus', stated as 'Clinical Focus')Clinical Focus (Details: http://terminology.hl7.org/CodeSystem/usage-context-type
             code focus = 'Clinical Focus', stated as 'Clinical Focus')ISO 3166-1 Codes for the representation of names of countries and their subdivisions
             — Part 1: Country code: 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.: Before starting and periodically during continuation of opioid therapy, clinicians
         should evaluate risk factors for opioid-related harms.: Kensaku Kawamoto, MD, PhD, MHS: , Bryn Rhodes: , Floyd Eisenberg, MD, MPH: ,
         Robert McClure, MD, MPH: : Checking if the trigger prescription meets the inclusion criteria for recommendation
           #8 workflow.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.

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    <value value="cdc-opioid-guidance"/> 
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  <name value="Cdcopioid08"/> 
  <title value="CDC Opioid Prescribing Guideline Recommendation #8"/> 
  <type> 
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      <code value="eca-rule"/> 
      <display value="ECA Rule"/> 
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  <status value="draft"/> 
  <date value="2018-03-19"/> 
  

  <publisher value="HL7 International / Clinical Decision Support"/> 
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  <description value="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."/> 
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        <code value="82423001"/> 
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      <code value="US"/> 
      <display value="United States of America"/> 
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  <purpose value="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 value="Before starting and periodically during continuation of opioid therapy, clinicians
   should evaluate risk factors for opioid-related harms."/> 
  <copyright value="© CDC 2016+."/> 
  <topic> 
    <text value="Opioid Prescribing"/> 
  </topic> 
  <author> 
    <name value="Kensaku Kawamoto, MD, PhD, MHS"/> 
  </author> 
  <author> 
    <name value="Bryn Rhodes"/> 
  </author> 
  <author> 
    <name value="Floyd Eisenberg, MD, MPH"/> 
  </author> 
  <author> 
    <name value="Robert McClure, MD, MPH"/> 
  </author> 
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    <display value="CDC guideline for prescribing opioids for chronic pain"/> 
    <document> 
      <url value="https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chro
      nic-pain---united-states-2016#420"/> 
    </document> 
  </relatedArtifact> 
  <relatedArtifact> 
    <type value="documentation"/> 
    <display value="MME Conversion Tables"/> 
    <document> 
      <url value="https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"/> 
    </document> 
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    <title value="Existing patient exhibits risk factors for opioid-related harms."/> 
    <description value="Checking if the trigger prescription meets the inclusion criteria for recommendation
     #8 workflow."/> 
    <documentation> 
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    <trigger> 
      <type value="named-event"/> 
      <name value="medication-prescribe"/> 
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    <condition> 
      <kind value="applicability"/> 
      <expression> 
        <description value="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."/> 
        

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        <expression value="Inclusion Criteria"/> 
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    <groupingBehavior value="visual-group"/> 
    <selectionBehavior value="exactly-one"/> 
    <dynamicValue> 
      <path value="action.description"/> 
      <expression> 
        

        <language value="text/cql-identifier"/> 
        <expression value="Get Detail"/> 
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    <dynamicValue> 
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    <action> 
      <description value="Will offer Naloxone instead"/> 
    </action> 
    <action> 
      <description value="Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo"/> 
    </action> 
    <action> 
      <description value="N/A - see comment; snooze 3 mo"/> 
    </action> 
  </action> 


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