Plandefinition-opioidcds-05 - FHIR v6.0.0-ballot2

FHIR CI-Build

This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions

Example PlanDefinition/opioidcds-05 (Narrative)

Clinical Decision Support Work Group

Maturity Level: N/A

Standards Status: Informative

Compartments: No defined compartments

This is the narrative for the resource. See also the XML, JSON or Turtle format. This example conforms to the profile PlanDefinition.

Generated Narrative: PlanDefinition opioidcds-05

StructureDefinition Work Group: cds

identifier: Uniform Resource Identifier (URI)/urn:oid:2.16.840.1.113883.4.642.11.1, cdc-opioid-guidance (use: official, )

version: 0.1.0

name: Cdcopioid05

title: CDC Opioid Prescribing Guideline Recommendation #5

type: ECA Rule

status: draft

date: 2017-04-23

publisher: HL7 International / Clinical Decision Support

contact: http://www.hl7.org/Special/committees/dss

description:

When opioids are started, providers should prescribe the lowest effective dosage.

UseContexts

Code

Value[x]

UsageContextType focus: Clinical Focus

Medication requested (situation)

UsageContextType focus: Clinical Focus

Chronic pain (finding)

jurisdiction: United States of America

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 opioids at any dosage, should carefully reassess evidence of individual benefits and risks when considering increasing dosage to ≥50 morphine milligram equivalents (MME)/day, and should avoid increasing dosage to ≥90 MME/day or carefully justify a decision to titrate dosage to >90 MME/day

copyright:

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
Documents

- Url

* https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420

relatedArtifact
type: documentation
display: MME Conversion Tables
Documents

- Url

* https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf

library: http://example.org/fhir/Library/opioidcds-recommendation-05

action
Strength of recommendation: Strong
Quality of evidence: Low quality
title: High risk for opioid overdose.
description:

Total morphine milligram equivalent (MME) exceeds recommended amount. Taper to less than 50.

Documentations

- Type

* documentation
Triggers

- Type Name

* named-event medication-prescribe
condition
kind: applicability
Expressions

- Description Language Expression

* Is total MME >= 50? text/cql Is MME 50 Or More?
groupingBehavior: visual-group
selectionBehavior: exactly-one
dynamicValue
path: action.title
Expressions

- Language Expression

* text/cql getSummary
dynamicValue
path: action.description
Expressions

- Language Expression

* text/cql getDetail
dynamicValue
path: activity.extension
Expressions

- Language Expression

* text/cql getIndicator
Actions

- Description

*
Will reduce dosage

*
Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo

*
Acute pain; snooze 1 mo

*
N/A - see comment (will be reviewed by medical director); snooze 3 mo

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.