CPG Opioid Prescribing Guideline Examples
1.0.0 - ci-build International flag

CPG Opioid Prescribing Guideline Examples, published by HL7 International - Clinical Decision Support WG. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/cpg-example-opioids/ and changes regularly. See the Directory of published versions

PlanDefinition: CDC Opioid Prescribing Guideline Recommendation #5 (Experimental)

Official URL: http://hl7.org/fhir/uv/cpg/opiods/PlanDefinition/opioidcds-r4-recommendation-05 Version: 1.0.0
Draft as of 2024-03-01 Computable Name: OpioidCDS_R4_Recommendation_05

Usage:Clinical Focus: Medication requested (situation), Clinical Focus: Chronic pain (finding)

Copyright/Legal: CDC 2016+

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

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.

Generated Narrative: PlanDefinition

Resource PlanDefinition "opioidcds-r4-recommendation-05"

Profile: CPG Computable Plan Definition

url: http://hl7.org/fhir/uv/cpg/opiods/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: 2024-03-01 19:34:30+0000

publisher: HL7 International - Clinical Decision Support WG

contact: HL7 International - Clinical Decision Support WG: http://www.hl7.org/Special/committees/dss/index.cfm

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

UseContexts

-CodeValue[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: 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:

relatedArtifact

type: documentation

display: MME Conversion Tables

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

document

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.

documentation

type: documentation

display: CDC guideline for prescribing opioids for chronic pain

url: https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmmwr%2Fvolumes%2F65%2Frr%2Frr6501e1er.htm

document

documentation

type: documentation

Triggers

-TypeName
*named-eventmedication-prescribe

condition

kind: applicability

Expressions

-DescriptionLanguageExpression
*Is total MME >= 50?text/cqlInclusion Criteria

groupingBehavior: visual-group

selectionBehavior: exactly-one

dynamicValue

path: action.title

Expressions

-LanguageExpression
*text/cqlGet Summary

dynamicValue

path: action.description

Expressions

-LanguageExpression
*text/cqlGet Detail

dynamicValue

path: activity.extension

Expressions

-LanguageExpression
*text/cqlGet Indicator

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