Generated Narrative with Details Narrative: PlanDefinition

url : http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-07

identifier : cdc-opioid-guidance (OFFICIAL) id: urn:oid:2.16.840.1.113883.4.642.11.6, id: cdc-opioid-guidance (use: OFFICIAL)

version : 0.1.0

name : cdc-opioid-07 Cdcopioid07

title : CDC Opioid Prescribing Guideline Recommendation #7

type : ECA Rule (Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'}) ( PlanDefinitionType #eca-rule)

status : draft

date : 19/03/2018 2018-03-19

publisher : Centers for Disease Control and Prevention (CDC)

description : Clinicians should evaluate benefits and harms with patients within 1 to 4 weeks of starting opioid therapy for chronic pain or of dose escalation. Clinicians should evaluate benefits and harms of continued therapy with patients every 3 months or more frequently.

UseContexts

-	useContext : , 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 (Details : {urn:iso:std:iso:3166 code 'US' = 'United States ( ISO 3166-1 Codes for the representation of America', given as 'United States names of America'}) 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 : If benefits do not outweigh harms of continued opioid therapy, clinicians should optimize other therapies and work with patients to taper opioids to lower dosages or to taper and discontinue opioids.

copyright : © CDC 2016+.

topic : Opioid Prescribing (Details ) ()

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 : Library/opioidcds-recommendation-07 http://example.org/fhir/Library/opioidcds-recommendation-07

action

title : Existing patient should be evaluated for risk of continued opioid therapy.

description : Checking if the trigger prescription meets the inclusion criteria for recommendation #7 workflow.

documentation

type : documentation

trigger document

Triggers

-	Type	Name
*	named-event	medication-prescribe

condition

kind : applicability

Conditions Expressions

-	Kind Description	Language	Expression
*	applicability Check whether the existing patient, without an end of life condition or risk assessment in the past 90 days, has taken an opioid-with-abuse-potential for 7 of the past 10 days or 63 of the past 90 days.	text/cql	Inclusion Criteria

groupingBehavior : visual-group

selectionBehavior : exactly-one

dynamicValue

path : action.title

Expressions

-	expression : Language	Expression
*	text/cql	Get Summary

dynamicValue

path : action.description

Expressions

-	expression : Language	Expression
*	text/cql	Get Detail

dynamicValue

path : action.extension

Expressions

-	expression : Language	Expression
*	text/cql	Get Indicator

Actions

-	Description
*	Will schedule assessment of risk for opioid use for the patient
*	Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo
*	N/A - see comment; snooze 3 mo