FHIR Clinical Guidelines (v1.0.0) (STU1)

Clinical Practice Guidelines, published by Clinical Decision Support WG. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/cqf-recommendations/ and changes regularly. See the Directory of published versions

PlanDefinition-opioidcds-r4-recommendation-05

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Generated Narrative

Resource "opioidcds-r4-recommendation-05"

url: http://fhir.org/guides/cdc/opioid-cds/PlanDefinition/opioidcds-r4-recommendation-05

version: 1.0.0

name: OpioidCDS_R4_Recommendation_05

title: CDC Opioid Prescribing Guideline Recommendation #5

type: ECA Rule (PlanDefinitionType#eca-rule)

status: draft

experimental: true

date: 2017-04-23

publisher: Centers for Disease Control and Prevention (CDC)

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

jurisdiction: World (m49.htm#001)

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: © CDC 2016+.

topic: Opioid Prescribing ()

author: Kensaku Kawamoto, MD, PhD, MHS: , Bryn Rhodes: , Floyd Eisenberg, MD, MPH: , Robert McClure, MD, MPH:

library: Opioid CDS R4 Logic for recommendation #5

action

title: High risk for opioid overdose.

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

condition

kind: applicability

groupingBehavior: visual-group

selectionBehavior: exactly-one

dynamicValue

path: action.title

dynamicValue

path: action.description

dynamicValue

path: activity.extension

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