2022 CDC Clinical Practice Guideline for Prescribing Opioids Implementation Guide
2022.1.0 - CI Build
2022 CDC Clinical Practice Guideline for Prescribing Opioids Implementation Guide
2022.1.0 - CI Build
2022 CDC Clinical Practice Guideline for Prescribing Opioids Implementation Guide, published by Centers for Disease Control and Prevention (CDC). This guide is not an authorized publication; it is the continuous build for version 2022.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/opioid-cds-r4/ and changes regularly. See the Directory of published versions
| Draft as of 2024-04-22 |
@prefix fhir: <http://hl7.org/fhir/> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix sct: <http://snomed.info/id/> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- a fhir:PlanDefinition ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "opioidcds-06"] ; # fhir:meta [ ( fhir:profile [ fhir:v "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition> ] [ fhir:v "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-publishableplandefinition"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-publishableplandefinition> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "extensions" ] ; fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">opioidcds-06</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Url: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"PlanDefinition-opioidcds-06.html\">Recommendation #6 - Prescribe Lowest Effective Dose and Duration</a></td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">2022.1.0</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Identifier: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>value: </b> <span>cdc-opioid-guidance</span>\n </p>\n \n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Name: </b></th>\n <td style=\"padding-left: 4px;\">PlanDefinition_Recommendation_06_Order_Sign</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">Recommendation #6 - Prescribe Lowest Effective Dose and Duration</td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Status: </b></th>\n <td style=\"padding-left: 4px;\">draft</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Experimental: </b></th>\n <td style=\"padding-left: 4px;\">true</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <b>system: </b> <span><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-plan-definition-type.html\">PlanDefinitionType</a></span>\n </p>\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>code: </b> <span>eca-rule</span>\n </p>\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>display: </b> <span>ECA Rule</span>\n </p>\n \n \n \n \n </td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Date: </b></th>\n <td style=\"padding-left: 4px;\">2024-04-22</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Publisher: </b></th>\n <td style=\"padding-left: 4px;\">Centers for Disease Control and Prevention (CDC)</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Description: </b></th>\n <td style=\"padding-left: 4px;\">When opioids are needed for acute pain, clinicians should prescribe no greater quantity than needed for the expected duration of pain severe enough to require opioids.</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><a name=\"effective-data-requirements\"> </a><b>Logic Definitions: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <table class=\"grid-dict\">\n <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n <tr>\n \n <td>OpioidCDSREC06</td>\n \n \n <td>Acute Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions</td>\n \n \n <td>0</td>\n \n </tr>\n </table>\n \n <pre><code class=\"language-cql\">define &quot;Acute Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions&quot;:\n ( Common.&quot;Is Opioid Analgesic with Ambulatory Misuse Potential?&quot;( ContextPrescriptions ) ) AmbulatoryOpioidPrescription\n where Routines.&quot;Is Acute Pain Prescription?&quot;( AmbulatoryOpioidPrescription )\n and Routines.&quot;Acute Pain Prescription Greater Than 7 Days?&quot;(AmbulatoryOpioidPrescription)</code></pre>\n \n <br/><br/>\n \n <table class=\"grid-dict\">\n <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n <tr>\n \n <td>OpioidCDSREC06</td>\n \n \n <td>Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential for Acute Pain</td>\n \n \n <td>1</td>\n \n </tr>\n </table>\n \n <pre><code class=\"language-cql\">define &quot;Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential for Acute Pain&quot;:\n exists( &quot;Acute Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions&quot; )</code></pre>\n \n <br/><br/>\n \n <table class=\"grid-dict\">\n <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n <tr>\n \n <td>OpioidCDSRoutines</td>\n \n \n <td>Patient Age Less Than 18</td>\n \n \n <td>2</td>\n \n </tr>\n </table>\n \n <pre><code class=\"language-cql\">define &quot;Patient Age Less Than 18&quot;:\n if (Config.&quot;Age Less than 18 Years Is Enabled&quot;) then\n AgeInYearsAt(Today()) &lt; 18\n else\n false</code></pre>\n \n <br/><br/>\n \n <table class=\"grid-dict\">\n <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n <tr>\n \n <td>OpioidCDSRoutines</td>\n \n \n <td>Condition Positive for Sickle Cell</td>\n \n \n <td>3</td>\n \n </tr>\n </table>\n \n <pre><code class=\"language-cql\">define &quot;Condition Positive for Sickle Cell&quot;:\n if (Config.&quot;Sickle Cell Check Enabled&quot;) then\n exists(\n Common.&quot;Positive Sickle Cell Condition&quot;\n ) else\n false</code></pre>\n \n <br/><br/>\n \n <table class=\"grid-dict\">\n <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n <tr>\n \n <td>OpioidCDSCommon</td>\n \n \n <td>US Core-Categorized Conditions</td>\n \n \n <td>4</td>\n \n </tr>\n </table>\n \n <pre><code class=\"language-cql\">// 3. Medications indicating end of life\n /* or exists (\n &quot;Medications Indicating End of Life&quot;\n ) */\ndefine &quot;US Core-Categorized Conditions&quot;:\n [Condition: category in &quot;Encounter Diagnosis Condition Category&quot;]\n union [Condition: category in &quot;Problem List Condition Category&quot;]\n union [Condition: category in &quot;US Core Health Concern Condition Category&quot;]</code></pre>\n \n <br/><br/>\n \n <table class=\"grid-dict\">\n <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n <tr>\n \n <td>OpioidCDSRoutines</td>\n \n \n <td>Conditions Indicating End Of Life Present</td>\n \n \n <td>5</td>\n \n </tr>\n </table>\n \n <pre><code class=\"language-cql\">define &quot;Conditions Indicating End Of Life Present&quot;:\n exists (\n Common.&quot;US Core-Categorized Conditions&quot; LLEC\n where LLEC.code in Common.&quot;Limited life expectancy conditions&quot;\n and LLEC.clinicalStatus in Common.&quot;Active Condition&quot;\n )</code></pre>\n \n <br/><br/>\n \n <table class=\"grid-dict\">\n <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n <tr>\n \n <td>OpioidCDSRoutines</td>\n \n \n <td>Is Active Cancer Treatment?</td>\n \n \n <td>6</td>\n \n </tr>\n </table>\n \n <pre><code class=\"language-cql\">define &quot;Is Active Cancer Treatment?&quot;:\n if (Config.&quot;Active Cancer Treatment Encounters Condition Is Enabled&quot;) then\n &quot;Has Two or More Encounters with Cancer Diagnosis During Encounter Period&quot;\n else\n false</code></pre>\n \n <br/><br/>\n \n <table class=\"grid-dict\">\n <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n <tr>\n \n <td>OpioidCDSRoutines</td>\n \n \n <td>Conditions Including Cancer To Exclude Opioid Management Indicating End-Stage Disease Present</td>\n \n \n <td>7</td>\n \n </tr>\n </table>\n \n <pre><code class=\"language-cql\">define &quot;Conditions Including Cancer To Exclude Opioid Management Indicating End-Stage Disease Present&quot;:\n if (Config.&quot;End-Stage Disease Criteria Enabled&quot;) then\n exists (\n Common.&quot;US Core-Categorized Conditions&quot; EOLC\n where EOLC.code in Common.&quot;Conditions likely terminal for opioid prescribing&quot;\n and EOLC.clinicalStatus in Common.&quot;Active Condition&quot;\n )\n else\n false</code></pre>\n \n <br/><br/>\n \n <table class=\"grid-dict\">\n <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n <tr>\n \n <td>OpioidCDSRoutines</td>\n \n \n <td>Is Opioid Review Useful?</td>\n \n \n <td>8</td>\n \n </tr>\n </table>\n \n <pre><code class=\"language-cql\">define &quot;Is Opioid Review Useful?&quot;:\n not &quot;Patient Age Less Than 18&quot;\n and not &quot;Condition Positive for Sickle Cell&quot;\n and not &quot;Conditions Indicating End Of Life Present&quot;\n and not &quot;Is Active Cancer Treatment?&quot;\n and not &quot;Conditions Including Cancer To Exclude Opioid Management Indicating End-Stage Disease Present&quot;</code></pre>\n \n <br/><br/>\n \n <table class=\"grid-dict\">\n <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n <tr>\n \n <td>OpioidCDSREC06</td>\n \n \n <td>Order is for Long-Acting Opioid</td>\n \n \n <td>9</td>\n \n </tr>\n </table>\n \n <pre><code class=\"language-cql\">define &quot;Order is for Long-Acting Opioid&quot;:\n exists (\n &quot;Acute Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions&quot; AmbulatoryOpioidPrescription\n where AmbulatoryOpioidPrescription.medication in Common.&quot;Extended release opioid with ambulatory misuse potential&quot;\n or Common.GetDurationInDays( AmbulatoryOpioidPrescription.dispenseRequest.expectedSupplyDuration ) &gt; 7 days\n )</code></pre>\n \n <br/><br/>\n \n <table class=\"grid-dict\">\n <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n <tr>\n \n <td>OpioidCDSREC06</td>\n \n \n <td>Inclusion Criteria</td>\n \n \n <td>10</td>\n \n </tr>\n </table>\n \n <pre><code class=\"language-cql\">define &quot;Inclusion Criteria&quot;:\n &quot;Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential for Acute Pain&quot;\n and Routines.&quot;Is Opioid Review Useful?&quot;\n and &quot;Order is for Long-Acting Opioid&quot;</code></pre>\n \n <br/><br/>\n \n <table class=\"grid-dict\">\n <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n <tr>\n \n <td>OpioidCDSREC06</td>\n \n \n <td>Exclusion Criteria</td>\n \n \n <td>11</td>\n \n </tr>\n </table>\n \n <pre><code class=\"language-cql\">define &quot;Exclusion Criteria&quot;:\n false</code></pre>\n \n <br/><br/>\n \n <table class=\"grid-dict\">\n <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n <tr>\n \n <td>OpioidCDSREC06</td>\n \n \n <td>Is Recommendation Applicable?</td>\n \n \n <td>12</td>\n \n </tr>\n </table>\n \n <pre><code class=\"language-cql\">define &quot;Is Recommendation Applicable?&quot;:\n &quot;Inclusion Criteria&quot;\n and not &quot;Exclusion Criteria&quot;</code></pre>\n \n <br/><br/>\n \n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Knowledge Capability: </b></th>\n <td style=\"padding-left: 4px;\">\n shareable computable executable publishable \n </td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Use Context: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr><th><b>code</b></th><th><b>value</b></th><th><b>display</b></th></tr>\n \n <tr>\n <td>focus</td>\n <td>182888003</td>\n <td>Medication requested (situation)</td>\n </tr>\n \n <tr>\n <td>focus</td>\n <td>274663001</td>\n <td>Acute pain (finding)</td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Jurisdiction: </b></th>\n <td style=\"padding-left: 4px;\">US</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Purpose: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>The 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain is intended to improve communication between clinicians and patients about the benefits and risks of pain treatments, including opioid therapy; improve the effectiveness and safety of pain treatment; mitigate pain; improve function and quality of life for patients with pain; and reduce risks associated with opioid pain therapy, including opioid use disorder, overdose, and death. The recommendations do not apply to pain related to sickle cell disease or cancer or to patients receiving palliative or end-of-life care.</p>\n</div></td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Usage: </b></th>\n <td style=\"padding-left: 4px;\">When the diagnosis and severity of acute pain warrant use of opioids, clinicians should prescribe no greater quantity than needed for the expected duration of pain severe enough to require opioids. For many common causes of nontraumatic, nonsurgical pain, when opioids are needed, a few days or less are often sufficient, and shorter courses can minimize the need to taper opioids to prevent withdrawal symptoms at the end of a course of opioids. However, durations should be individualized to the patient's clinical circumstances.</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Copyright: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>© CDC 2016+.</p>\n</div></td>\n </tr>\n \n \n \n \n \n \n <tr>\n <th scope=\"row\"><b>Related Artifacts: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <p><b>Documentation</b></p>\n <ul>\n \n <li>\n <a href=\"https://www.cdc.gov/mmwr/volumes/71/rr/pdfs/rr7103a1-H.pdf\"> 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain</a>\n </li>\n \n </ul>\n \n \n \n \n \n \n \n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Libraries: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr><td><a href=\"Library-OpioidCDSREC06.html\">Library - Recommendation #6 - Prescribe Lowest Effective Dose and Duration</a></td></tr>\n \n </table>\n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Actions: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr>\n <td>\n <b> When Treating Acute Pain, Prescribe No More Opioids Than Needed:</b> Please verify that the opioid order quantity and duration are no more than needed for the expected duration of pain severe enough to require opioids.\r\n\r\nFor guidance regarding prescribing opioids for acute pain, see [Recommendation 6 of the 2022 CDC Clinical Practice Guideline](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#Recommendation6).<br/>\n <b>When:</b> <i>named-event:</i> order-sign<br/>\n <b>If:</b> <i>applicability:</i> Check whether the current order is for an opioid with ambulatory misuse potential for acute pain with an intended duration of more than 7 days and if an opioid review is appropriate for the patient <i>(Is Recommendation Applicable?)</i><br/>\n <b>Then:</b>\n \n <table class=\"grid-dict\">\n \n <tr>\n <td>\n <b> :</b> Document - Will adjust opioid order<br/>\n \n \n <b>Then:</b>\n \n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n <b> :</b> Snooze* - Benefits of opioid therapy duration outweigh risks, snooze 3 months<br/>\n \n \n <b>Then:</b>\n \n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n <b> :</b> Snooze* - N/A see comment, snooze 3 months<br/>\n \n \n <b>Then:</b>\n \n \n \n \n </td>\n </tr>\n \n </table>\n \n </td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n </table>\n</div>" ] ; # fhir:contained ( [ a fhir:Library ; fhir:id [ fhir:v "effective-data-requirements" ] ; fhir:status [ fhir:v "active" ] ; fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/library-type"^^xsd:anyURI ] ; fhir:code [ fhir:v "module-definition" ] ] ) ] ; ( fhir:relatedArtifact [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "Library Common" ] ; fhir:resource [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommon|2022.1.0"^^xsd:anyURI ; fhir:link <http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommon|2022.1.0> ] ] [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "Library FHIRHelpers" ] ; fhir:resource [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/Library/FHIRHelpers|4.0.1"^^xsd:anyURI ; fhir:link <http://fhir.org/guides/cdc/opioid-cds/Library/FHIRHelpers|4.0.1> ] ] [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "Library Routines" ] ; fhir:resource [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSRoutines|2022.1.0"^^xsd:anyURI ; fhir:link <http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSRoutines|2022.1.0> ] ] [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "Value set Opioid analgesics with ambulatory misuse potential" ] ; fhir:resource [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-analgesics-with-ambulatory-misuse-potential"^^xsd:anyURI ; fhir:link <http://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-analgesics-with-ambulatory-misuse-potential> ] ] [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "Value set Community" ] ; fhir:resource [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/ValueSet/medicationrequest-category-community"^^xsd:anyURI ; fhir:link <http://fhir.org/guides/cdc/opioid-cds/ValueSet/medicationrequest-category-community> ] ] [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "Value set Encounter Diagnosis Condition Category" ] ; fhir:resource [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-encounter-diagnosis-category"^^xsd:anyURI ; fhir:link <http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-encounter-diagnosis-category> ] ] [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "Value set Problem List Condition Category" ] ; fhir:resource [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-problem-list-category"^^xsd:anyURI ; fhir:link <http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-problem-list-category> ] ] [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "Value set US Core Health Concern Condition Category" ] ; fhir:resource [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category"^^xsd:anyURI ; fhir:link <http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category> ] ] [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "Value set Limited life expectancy conditions" ] ; fhir:resource [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/ValueSet/limited-life-expectancy-conditions"^^xsd:anyURI ; fhir:link <http://fhir.org/guides/cdc/opioid-cds/ValueSet/limited-life-expectancy-conditions> ] ] [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "Value set Active Condition" ] ; fhir:resource [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-clinical-status-active"^^xsd:anyURI ; fhir:link <http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-clinical-status-active> ] ] [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "Value set Extended release opioid with ambulatory misuse potential" ] ; fhir:resource [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/ValueSet/extended-release-opioid-with-ambulatory-misuse-potential"^^xsd:anyURI ; fhir:link <http://fhir.org/guides/cdc/opioid-cds/ValueSet/extended-release-opioid-with-ambulatory-misuse-potential> ] ] ) ; ( fhir:parameter [ fhir:name [ fhir:v "ContextPrescriptions" ] ; fhir:use [ fhir:v "in" ] ; fhir:min [ fhir:v "0"^^xsd:integer ] ; fhir:max [ fhir:v "*" ] ; fhir:type [ fhir:v "MedicationRequest" ] ] [ fhir:name [ fhir:v "Is Recommendation Applicable?" ] ; fhir:use [ fhir:v "out" ] ; fhir:min [ fhir:v "0"^^xsd:integer ] ; fhir:max [ fhir:v "1" ] ; fhir:type [ fhir:v "boolean" ] ] ) ; ( fhir:dataRequirement [ fhir:type [ fhir:v "Medication" ] ; ( fhir:profile [ fhir:v "http://hl7.org/fhir/StructureDefinition/Medication"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/StructureDefinition/Medication> ] ) ; ( fhir:mustSupport [ fhir:v "id" ] ) ; ( fhir:codeFilter [ fhir:path [ fhir:v "id" ] ] ) ] [ fhir:type [ fhir:v "Condition" ] ; ( fhir:profile [ fhir:v "http://hl7.org/fhir/StructureDefinition/Condition"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/StructureDefinition/Condition> ] ) ; ( fhir:mustSupport [ fhir:v "category" ] ) ; ( fhir:codeFilter [ fhir:path [ fhir:v "category" ] ; fhir:valueSet [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-encounter-diagnosis-category"^^xsd:anyURI ; fhir:link <http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-encounter-diagnosis-category> ] ] ) ] [ fhir:type [ fhir:v "Condition" ] ; ( fhir:profile [ fhir:v "http://hl7.org/fhir/StructureDefinition/Condition"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/StructureDefinition/Condition> ] ) ; ( fhir:mustSupport [ fhir:v "category" ] ) ; ( fhir:codeFilter [ fhir:path [ fhir:v "category" ] ; fhir:valueSet [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-problem-list-category"^^xsd:anyURI ; fhir:link <http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-problem-list-category> ] ] ) ] [ fhir:type [ fhir:v "Condition" ] ; ( fhir:profile [ fhir:v "http://hl7.org/fhir/StructureDefinition/Condition"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/StructureDefinition/Condition> ] ) ; ( fhir:mustSupport [ fhir:v "category" ] ) ; ( fhir:codeFilter [ fhir:path [ fhir:v "category" ] ; fhir:valueSet [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category"^^xsd:anyURI ; fhir:link <http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category> ] ] ) ] ) ] ) ; # fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability"^^xsd:anyURI ] ; fhir:value [ fhir:v "shareable" ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability"^^xsd:anyURI ] ; fhir:value [ fhir:v "computable" ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability"^^xsd:anyURI ] ; fhir:value [ fhir:v "executable" ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability"^^xsd:anyURI ] ; fhir:value [ fhir:v "publishable" ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem"^^xsd:anyURI ] ; fhir:value [ a fhir:Reference ; fhir:reference [ fhir:v "Device/cqf-tooling" ] ] ] [ fhir:id [ fhir:v "effective-data-requirements" ] ; fhir:url [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/StructureDefinition/effectiveDataRequirements"^^xsd:anyURI ] ; fhir:value [ a fhir:Reference ; fhir:reference [ fhir:v "#effective-data-requirements" ] ] ] [ ( fhir:extension [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ; fhir:value [ fhir:v "OpioidCDSREC06" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ] ; fhir:value [ fhir:v "Acute Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ] ; fhir:value [ fhir:v "define \"Acute Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions\":\n ( Common.\"Is Opioid Analgesic with Ambulatory Misuse Potential?\"( ContextPrescriptions ) ) AmbulatoryOpioidPrescription\n where Routines.\"Is Acute Pain Prescription?\"( AmbulatoryOpioidPrescription )\n and Routines.\"Acute Pain Prescription Greater Than 7 Days?\"(AmbulatoryOpioidPrescription)" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ; fhir:value [ fhir:v "0"^^xsd:integer ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ; fhir:value [ fhir:v "OpioidCDSREC06" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ] ; fhir:value [ fhir:v "Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential for Acute Pain" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ] ; fhir:value [ fhir:v "define \"Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential for Acute Pain\":\n exists( \"Acute Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions\" )" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ; fhir:value [ fhir:v "1"^^xsd:integer ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ; fhir:value [ fhir:v "OpioidCDSRoutines" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ] ; fhir:value [ fhir:v "Patient Age Less Than 18" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ] ; fhir:value [ fhir:v "define \"Patient Age Less Than 18\":\n if (Config.\"Age Less than 18 Years Is Enabled\") then\n AgeInYearsAt(Today()) < 18\n else\n false" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ; fhir:value [ fhir:v "2"^^xsd:integer ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ; fhir:value [ fhir:v "OpioidCDSRoutines" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ] ; fhir:value [ fhir:v "Condition Positive for Sickle Cell" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ] ; fhir:value [ fhir:v "define \"Condition Positive for Sickle Cell\":\n if (Config.\"Sickle Cell Check Enabled\") then\n exists(\n Common.\"Positive Sickle Cell Condition\"\n ) else\n false" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ; fhir:value [ fhir:v "3"^^xsd:integer ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ; fhir:value [ fhir:v "OpioidCDSCommon" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ] ; fhir:value [ fhir:v "US Core-Categorized Conditions" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ] ; fhir:value [ fhir:v "// 3. Medications indicating end of life\n /* or exists (\n \"Medications Indicating End of Life\"\n ) */\ndefine \"US Core-Categorized Conditions\":\n [Condition: category in \"Encounter Diagnosis Condition Category\"]\n union [Condition: category in \"Problem List Condition Category\"]\n union [Condition: category in \"US Core Health Concern Condition Category\"]" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ; fhir:value [ fhir:v "4"^^xsd:integer ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ; fhir:value [ fhir:v "OpioidCDSRoutines" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ] ; fhir:value [ fhir:v "Conditions Indicating End Of Life Present" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ] ; fhir:value [ fhir:v "define \"Conditions Indicating End Of Life Present\":\n exists (\n Common.\"US Core-Categorized Conditions\" LLEC\n where LLEC.code in Common.\"Limited life expectancy conditions\"\n and LLEC.clinicalStatus in Common.\"Active Condition\"\n )" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ; fhir:value [ fhir:v "5"^^xsd:integer ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ; fhir:value [ fhir:v "OpioidCDSRoutines" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ] ; fhir:value [ fhir:v "Is Active Cancer Treatment?" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ] ; fhir:value [ fhir:v "define \"Is Active Cancer Treatment?\":\n if (Config.\"Active Cancer Treatment Encounters Condition Is Enabled\") then\n \"Has Two or More Encounters with Cancer Diagnosis During Encounter Period\"\n else\n false" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ; fhir:value [ fhir:v "6"^^xsd:integer ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ; fhir:value [ fhir:v "OpioidCDSRoutines" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ] ; fhir:value [ fhir:v "Conditions Including Cancer To Exclude Opioid Management Indicating End-Stage Disease Present" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ] ; fhir:value [ fhir:v "define \"Conditions Including Cancer To Exclude Opioid Management Indicating End-Stage Disease Present\":\n if (Config.\"End-Stage Disease Criteria Enabled\") then\n exists (\n Common.\"US Core-Categorized Conditions\" EOLC\n where EOLC.code in Common.\"Conditions likely terminal for opioid prescribing\"\n and EOLC.clinicalStatus in Common.\"Active Condition\"\n )\n else\n false" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ; fhir:value [ fhir:v "7"^^xsd:integer ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ; fhir:value [ fhir:v "OpioidCDSRoutines" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ] ; fhir:value [ fhir:v "Is Opioid Review Useful?" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ] ; fhir:value [ fhir:v "define \"Is Opioid Review Useful?\":\n not \"Patient Age Less Than 18\"\n and not \"Condition Positive for Sickle Cell\"\n and not \"Conditions Indicating End Of Life Present\"\n and not \"Is Active Cancer Treatment?\"\n and not \"Conditions Including Cancer To Exclude Opioid Management Indicating End-Stage Disease Present\"" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ; fhir:value [ fhir:v "8"^^xsd:integer ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ; fhir:value [ fhir:v "OpioidCDSREC06" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ] ; fhir:value [ fhir:v "Order is for Long-Acting Opioid" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ] ; fhir:value [ fhir:v "define \"Order is for Long-Acting Opioid\":\n exists (\n \"Acute Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions\" AmbulatoryOpioidPrescription\n where AmbulatoryOpioidPrescription.medication in Common.\"Extended release opioid with ambulatory misuse potential\"\n or Common.GetDurationInDays( AmbulatoryOpioidPrescription.dispenseRequest.expectedSupplyDuration ) > 7 days\n )" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ; fhir:value [ fhir:v "9"^^xsd:integer ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ; fhir:value [ fhir:v "OpioidCDSREC06" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ] ; fhir:value [ fhir:v "Inclusion Criteria" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ] ; fhir:value [ fhir:v "define \"Inclusion Criteria\":\n \"Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential for Acute Pain\"\n and Routines.\"Is Opioid Review Useful?\"\n and \"Order is for Long-Acting Opioid\"" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ; fhir:value [ fhir:v "10"^^xsd:integer ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ; fhir:value [ fhir:v "OpioidCDSREC06" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ] ; fhir:value [ fhir:v "Exclusion Criteria" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ] ; fhir:value [ fhir:v "define \"Exclusion Criteria\":\n false" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ; fhir:value [ fhir:v "11"^^xsd:integer ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ; fhir:value [ fhir:v "OpioidCDSREC06" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ] ; fhir:value [ fhir:v "Is Recommendation Applicable?" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ] ; fhir:value [ fhir:v "define \"Is Recommendation Applicable?\":\n \"Inclusion Criteria\"\n and not \"Exclusion Criteria\"" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ; fhir:value [ fhir:v "12"^^xsd:integer ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ] ] [ fhir:id [ fhir:v "effective-data-requirements" ] ; fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements"^^xsd:anyURI ] ; fhir:value [ a fhir:Reference ; fhir:reference [ fhir:v "#effective-data-requirements" ] ] ] ) ; # fhir:url [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/PlanDefinition/opioidcds-06"^^xsd:anyURI] ; # fhir:identifier ( [ fhir:use [ fhir:v "official" ] ; fhir:value [ fhir:v "cdc-opioid-guidance" ] ] ) ; # fhir:version [ fhir:v "2022.1.0"] ; # fhir:name [ fhir:v "PlanDefinition_Recommendation_06_Order_Sign"] ; # fhir:title [ fhir:v "Recommendation #6 - Prescribe Lowest Effective Dose and Duration"] ; # fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/plan-definition-type"^^xsd:anyURI ] ; fhir:code [ fhir:v "eca-rule" ] ; fhir:display [ fhir:v "ECA Rule" ] ] ) ] ; # fhir:status [ fhir:v "draft"] ; # fhir:experimental [ fhir:v "true"^^xsd:boolean] ; # fhir:date [ fhir:v "2024-04-22"^^xsd:date] ; # fhir:publisher [ fhir:v "Centers for Disease Control and Prevention (CDC)"] ; # fhir:contact ( [ ( fhir:telecom [ fhir:system [ fhir:v "url" ] ; fhir:value [ fhir:v "https://www.cdc.gov" ] ] ) ] ) ; # fhir:description [ fhir:v "When opioids are needed for acute pain, clinicians should prescribe no greater quantity than needed for the expected duration of pain severe enough to require opioids."] ; # fhir:useContext ( [ fhir:code [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/usage-context-type"^^xsd:anyURI ] ; fhir:code [ fhir:v "focus" ] ; fhir:display [ fhir:v "Clinical Focus" ] ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ a sct:182888003 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "182888003" ] ; fhir:display [ fhir:v "Medication requested (situation)" ] ] ) ] ] [ fhir:code [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/usage-context-type"^^xsd:anyURI ] ; fhir:code [ fhir:v "focus" ] ; fhir:display [ fhir:v "Clinical Focus" ] ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ a sct:274663001 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "274663001" ] ; fhir:display [ fhir:v "Acute pain (finding)" ] ] ) ] ] ) ; # fhir:jurisdiction ( [ ( fhir:coding [ fhir:system [ fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ] ; fhir:code [ fhir:v "US" ] ; fhir:display [ fhir:v "United States of America" ] ] ) ] ) ; # fhir:purpose [ fhir:v "The 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain is intended to improve communication between clinicians and patients about the benefits and risks of pain treatments, including opioid therapy; improve the effectiveness and safety of pain treatment; mitigate pain; improve function and quality of life for patients with pain; and reduce risks associated with opioid pain therapy, including opioid use disorder, overdose, and death. The recommendations do not apply to pain related to sickle cell disease or cancer or to patients receiving palliative or end-of-life care."] ; # fhir:usage [ fhir:v "When the diagnosis and severity of acute pain warrant use of opioids, clinicians should prescribe no greater quantity than needed for the expected duration of pain severe enough to require opioids. For many common causes of nontraumatic, nonsurgical pain, when opioids are needed, a few days or less are often sufficient, and shorter courses can minimize the need to taper opioids to prevent withdrawal symptoms at the end of a course of opioids. However, durations should be individualized to the patient's clinical circumstances."] ; # fhir:copyright [ fhir:v "© CDC 2016+."] ; # fhir:topic ( [ fhir:text [ fhir:v "Opioid Prescribing" ] ] ) ; # fhir:author ( [ fhir:name [ fhir:v "Kensaku Kawamoto, MD, PhD, MHS" ] ] [ fhir:name [ fhir:v "Bryn Rhodes" ] ] [ fhir:name [ fhir:v "Floyd Eisenberg, MD, MPH" ] ] [ fhir:name [ fhir:v "Robert McClure, MD, MPH" ] ] ) ; # fhir:relatedArtifact ( [ fhir:type [ fhir:v "documentation" ] ; fhir:display [ fhir:v "2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain" ] ; fhir:url [ fhir:v "https://www.cdc.gov/mmwr/volumes/71/rr/pdfs/rr7103a1-H.pdf"^^xsd:anyURI ] ; fhir:document [ fhir:contentType [ fhir:v "application/pdf" ] ; fhir:language [ fhir:v "en-US" ] ; fhir:url [ fhir:v "https://www.cdc.gov/mmwr/volumes/71/rr/pdfs/rr7103a1-H.pdf"^^xsd:anyURI ] ] ] ) ; # fhir:library ( [ fhir:v "http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSREC06"^^xsd:anyURI ; fhir:link <http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSREC06> ] ) ; # fhir:action ( [ fhir:title [ fhir:v "When Treating Acute Pain, Prescribe No More Opioids Than Needed" ] ; fhir:description [ fhir:v "Please verify that the opioid order quantity and duration are no more than needed for the expected duration of pain severe enough to require opioids.\r\n\r\nFor guidance regarding prescribing opioids for acute pain, see [Recommendation 6 of the 2022 CDC Clinical Practice Guideline](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#Recommendation6)." ] ; fhir:priority [ fhir:v "urgent" ] ; ( fhir:documentation [ fhir:type [ fhir:v "documentation" ] ; fhir:url [ fhir:v "https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#Recommendation6:~:text=to%20require%20opioids-,(recommendation%20category%3A%20A%3B%20evidence%20type%3A%204).,-Implementation%20Considerations"^^xsd:anyURI ] ; fhir:document [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/recommendation-strength"^^xsd:anyURI ] ; fhir:code [ fhir:v "strong" ] ; fhir:display [ fhir:v "Strong" ] ] ) ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/evidence-quality"^^xsd:anyURI ] ; fhir:code [ fhir:v "very-low" ] ; fhir:display [ fhir:v "Very low quality" ] ] ) ] ] ) ; fhir:url [ fhir:v "https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#Recommendation6:~:text=to%20require%20opioids-,(recommendation%20category%3A%20A%3B%20evidence%20type%3A%204).,-Implementation%20Considerations"^^xsd:anyURI ] ] ] ) ; ( fhir:trigger [ fhir:type [ fhir:v "named-event" ] ; fhir:name [ fhir:v "order-sign" ] ] ) ; ( fhir:condition [ fhir:kind [ fhir:v "applicability" ] ; fhir:expression [ fhir:description [ fhir:v "Check whether the current order is for an opioid with ambulatory misuse potential for acute pain with an intended duration of more than 7 days and if an opioid review is appropriate for the patient" ] ; fhir:language [ fhir:v "text/cql.identifier" ] ; fhir:expression [ fhir:v "Is Recommendation Applicable?" ] ] ] ) ; fhir:groupingBehavior [ fhir:v "visual-group" ] ; fhir:selectionBehavior [ fhir:v "any" ] ; ( fhir:action [ fhir:description [ fhir:v "Document - Will adjust opioid order" ] ] [ fhir:description [ fhir:v "Snooze* - Benefits of opioid therapy duration outweigh risks, snooze 3 months" ] ] [ fhir:description [ fhir:v "Snooze* - N/A see comment, snooze 3 months" ] ] ) ] ) . #
IG © 2019+ Centers for Disease Control and Prevention (CDC). Package fhir.cdc.opioid-cds-r4#2022.1.0 based on FHIR 4.0.1. Generated 2024-04-22
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