Generated Narrative: PlanDefinition

StructureDefinition Work Group : cds

url : http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-04

identifier : id: urn:oid:2.16.840.1.113883.4.642.11.4, id:  # urn:oid:2.16.840.1.113883.4.642.11.4, id: cdc-opioid-guidance (use: OFFICIAL)

version : 0.1.0

name : Cdcopioid04

title : CDC Opioid Prescribing Guideline Recommendation #4

type : ECA Rule ( PlanDefinitionType #eca-rule)

status : draft

date : 2018-03-19

publisher : Centers for Disease Control and Prevention (CDC) HL7 International / Clinical Decision Support

contact :

description : When starting opioid therapy for chronic pain, clinicians should prescribe immediate-release opioids instead of extended-release/long-acting (ER/LA) opioids.

UseContexts

-	Code	Value[x]
*	Clinical Focus (Details: http://terminology.hl7.org/CodeSystem/usage-context-type code focus = 'Clinical Focus', stated as 'Clinical Focus')	Medication requested (situation) ( SNOMED CT #182888003)
*	Clinical Focus (Details: http://terminology.hl7.org/CodeSystem/usage-context-type code focus = 'Clinical Focus', stated as 'Clinical Focus')	Chronic pain (finding) ( SNOMED CT #82423001)

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 : Providers should use caution when prescribing extended-release/long-acting (ER/LA) opioids as they carry a higher risk and negligible benefit compared to immediate-release opioids.

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-04

action

title : Extended-release opioid prescription triggered.

description : Checking if the trigger prescription meets the inclusion criteria for recommendation #4 workflow.

documentation

type : documentation

document

Triggers

-	Type	Name
*	named-event	medication-prescribe

condition

kind : applicability

Expressions

-	Description	Language	Expression
*	Check whether the opioid prescription for the existing patient is extended-release without any opioids-with-abuse-potential prescribed in the past 90 days.	text/cql	Inclusion Criteria

groupingBehavior : visual-group

selectionBehavior : exactly-one

dynamicValue

path : action.title

Expressions

-	Language	Expression
*	text/cql	Get Summary

dynamicValue

path : action.description

Expressions

-	Language	Expression
*	text/cql	Get Detail

dynamicValue

path : activity.extension

Expressions

-	Language	Expression
*	text/cql	Get Indicator

Actions

-	Description
*	Will precribe immediate release
*	Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo
*	N/A - see comment; snooze 3 mo