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Resource "opioidcds-08" Version "1" (PlanDefinition)

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Generated Narrative with Details

id: opioidcds-08

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

identifier: cdc-opioid-guidance (OFFICIAL)

version: 0.1.0

name: PlanDefinition - Recommendation #8 Workflow

title: CDC Opioid Prescribing Guideline Recommendation #8

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

status: draft

date: Mar 19, 2018

publisher: Centers for Disease Control and Prevention (CDC)

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.

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.

useContext: ,

jurisdiction: United States of America (Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})

topic: Opioid Prescribing (Details )

contributor: , , ,

copyright: © CDC 2016+.

relatedArtifact:

library: Generated Summary: id: opioidcds-recommendation-08; OpioidCDS_REC_08 (OFFICIAL); version: 0.1.0; name: Library - Logic for Recommendation #8; title: Opioid CDS Logic for recommendation #8; status: active; Logic Library; date: Apr 15, 2018 1:49:09 PM; publisher: Centers for Disease Control and Prevention (CDC); description: Opioid decision support logic to consider offering Naloxone when factors that increase risk for opioid overdose are present.; purpose: The purpose of this library is to determine whether increased risks for opioid overdose are present.; usage: This library is used to recommend the prescriber/user to consider offering Naloxone when increased risks for opioid overdose are present.; United States of America; Opioid Prescribing;

Exception generating Narrative: type org.hl7.fhir.r4.model.Contributor not handled yet


<?xml version="1.0" encoding="UTF-8"?>
<PlanDefinition xmlns="http://hl7.org/fhir">
  <id value="opioidcds-08"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2018-09-06T12:42:28.750Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: opioidcds-08</p>
      <p>
        <b>url</b>:
        <a href="http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-08">http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-08</a>
      </p>
      <p>
        <b>identifier</b>: cdc-opioid-guidance (OFFICIAL)</p>
      <p>
        <b>version</b>: 0.1.0</p>
      <p>
        <b>name</b>: PlanDefinition - Recommendation #8 Workflow</p>
      <p>
        <b>title</b>: CDC Opioid Prescribing Guideline Recommendation #8</p>
      <p>
        <b>type</b>: ECA Rule
        <span style="background: LightGoldenRodYellow">(Details : {http://hl7.org/fhir/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})</span>
      </p>
      <p>
        <b>status</b>: draft</p>
      <p>
        <b>date</b>: Mar 19, 2018</p>
      <p>
        <b>publisher</b>: Centers for Disease Control and Prevention (CDC)</p>
      <p>
        <b>description</b>: 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 (&#8805;50 MME/day), or concurrent benzodiazepine use, are present.</p>
      <p>
        <b>purpose</b>: CDC&#8217;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.</p>
      <p>
        <b>usage</b>: Before starting and periodically during continuation of opioid therapy, clinicians should evaluate risk factors for opioid-related harms.</p>
      <p>
        <b>useContext</b>: , </p>
      <p>
        <b>jurisdiction</b>: United States of America
        <span style="background: LightGoldenRodYellow">(Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})</span>
      </p>
      <p>
        <b>topic</b>: Opioid Prescribing
        <span style="background: LightGoldenRodYellow">(Details )</span>
      </p>
      <p>
        <b>contributor</b>: , , , </p>
      <p>
        <b>copyright</b>: &#169; CDC 2016+.</p>
      <p>
        <b>relatedArtifact</b>: </p>
      <p>
        <b>library</b>:
        <a href="Library-opioidcds-recommendation-08.html">Generated Summary: id: opioidcds-recommendation-08 OpioidCDS_REC_08 (OFFICIAL) version: 0.1.0 name: Library - Logic for Recommendation #8 title: Opioid CDS Logic for recommendation #8 status: active
          <span title="Codes: {http://hl7.org/fhir/library-type logic-library}">Logic Library</span> date: Apr 15, 2018 1:49:09 PM publisher: Centers for Disease Control and Prevention (CDC) description: Opioid decision support logic to consider offering Naloxone when factors that increase risk for opioid overdose are present. purpose: The purpose of this library is to determine whether increased risks for opioid overdose are present. usage: This library is used to recommend the prescriber/user to consider offering Naloxone when increased risks for opioid overdose are present.
          <span title="Codes: {urn:iso:std:iso:3166 US}">United States of America</span>
          <span title="Codes: ">Opioid Prescribing</span> </a>
      </p>
      <p>
        <b style="color: maroon">Exception generating Narrative: type org.hl7.fhir.r4.model.Contributor not handled yet</b>
      </p>
    </div>
  </text>
  <url value="http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-08"/>
  <identifier>
    <use value="official"/>
    <value value="cdc-opioid-guidance"/>
  </identifier>
  <version value="0.1.0"/>
  <name value="PlanDefinition - Recommendation #8 Workflow"/>
  <title value="CDC Opioid Prescribing Guideline Recommendation #8"/>
  <type>
    <coding>
      <system value="http://hl7.org/fhir/plan-definition-type"/>
      <code value="eca-rule"/>
      <display value="ECA Rule"/>
    </coding>
  </type>
  <status value="draft"/>
  <date value="2018-03-19"/>
  <publisher value="Centers for Disease Control and Prevention (CDC)"/>
  <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 (&#8805;50 MME/day), or concurrent benzodiazepine use, are present."/>
  <purpose value="CDC&#8217;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."/>
  <useContext>
    <code>
      <system value="http://hl7.org/fhir/usage-context-type"/>
      <code value="focus"/>
      <display value="Clinical Focus"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="182888003"/>
        <display value="Medication requested (situation)"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <useContext>
    <code>
      <system value="http://hl7.org/fhir/usage-context-type"/>
      <code value="focus"/>
      <display value="Clinical Focus"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="82423001"/>
        <display value="Chronic pain (finding)"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <topic>
    <text value="Opioid Prescribing"/>
  </topic>
  <contributor>
    <type value="author"/>
    <name value="Kensaku Kawamoto, MD, PhD, MHS"/>
  </contributor>
  <contributor>
    <type value="author"/>
    <name value="Bryn Rhodes"/>
  </contributor>
  <contributor>
    <type value="author"/>
    <name value="Floyd Eisenberg, MD, MPH"/>
  </contributor>
  <contributor>
    <type value="author"/>
    <name value="Robert McClure, MD, MPH"/>
  </contributor>
  <copyright value="&#169; CDC 2016+."/>
  <relatedArtifact>
    <type value="documentation"/>
    <display value="MME Conversion Tables"/>
    <url value="https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"/>
  </relatedArtifact>
  <library>
    <reference value="Library/opioidcds-recommendation-08"/>
  </library>
  <action>
    <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>
      <type value="documentation"/>
      <display value="CDC guideline for prescribing opioids for chronic pain"/>
      <url value="https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"/>
    </documentation>
    <documentation>
      <type value="documentation"/>
      <document>
        <extension url="http://hl7.org/fhir/StructureDefinition/cqif-strengthOfRecommendation">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/recommendation-strength"/>
              <code value="strong"/>
              <display value="Strong"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/cqif-qualityOfEvidence">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/evidence-quality"/>
              <code value="very-low"/>
              <display value="Very Low quality"/>
            </coding>
          </valueCodeableConcept>
        </extension>
      </document>
    </documentation>
    <triggerDefinition>
      <type value="named-event"/>
      <eventName value="medication-prescribe"/>
    </triggerDefinition>
    <condition>
      <kind value="applicability"/>
      <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 a average MME greater than 50 mg/day."/>
      <language value="text/cql"/>
      <expression value="Inclusion Criteria"/>
    </condition>
    <groupingBehavior value="visual-group"/>
    <selectionBehavior value="exactly-one"/>
    <dynamicValue>
      <path value="action.description"/>
      <expression value="Get Detail"/>
    </dynamicValue>
    <dynamicValue>
      <path value="action.title"/>
      <expression value="Get Summary"/>
    </dynamicValue>
    <dynamicValue>
      <path value="action.extension"/>
      <expression value="Get Indicator"/>
    </dynamicValue>
    <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>
</PlanDefinition>