Id: library-OpioidCDSREC01 Type: logic-library Version: 2022.1.0 Status: active Related: type: depends-on Resource: http://fhir.org/guides/cdc/opioid-cds/Library/FHIRHelpers type: depends-on Resource: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommon type: depends-on Resource: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSRoutines Content: type: text/cql library OpioidCDSREC01 version '2022.1.0' using FHIR version '4.0.1' include FHIRHelpers version '4.0.1' called FHIRHelpers include OpioidCDSCommon version '2022.1.0' called Common include OpioidCDSRoutines version '2022.1.0' called Routines /* ** ** Recommendation #1 ** Nonpharmacologic therapy and nonopioid pharmacologic therapy are preferred ** for acute pain. Clinicians should consider opioid therapy only if expected ** benefits for both pain and function are anticipated to outweigh risks to the ** patient. If opioids are used, they should be combined with nonpharmacologic ** therapy and nonopioid pharmacologic therapy, as appropriate ** (recommendation category: A, evidence type: 3). ** ** When ** Prescription is for treating acute pain ** Provider is prescribing an opioid with ambulatory misuse potential in the outpatient setting ** Opioid review is useful for this patient: ** Patient is 18 or over ** Patient does not have findings indicating limited life expectancy ** Patient does not have orders for therapies indicating end of life care ** Patient is not undergoing active cancer treatment: ** Patient has had at least 2 encounters within the past year with any diagnosis of cancer ** Patient is opioid naive: ** No indication of opioid use in the past 90 days from a prescription, self report (for future implementation), or a dispensing event (for future implementation) ** Then ** Recommend the use of nonpharmacologic therapy and nonopioid pharmacologic therapy as an alternative. Potential actions include: ** Document reason for opioid use ** Document that alternative therapy was attempted, snooze 3 months ** N/A - see comment, snooze 3 months ** Select from order set for alternative therapies ** Remove triggering medication ** */ // META: Plan Definition: http://fhir.org/guides/cdc/opioid-cds-r4/PlanDefinition/opioid-cds-01 parameter ContextPrescriptions List<FHIR.MedicationRequest> context Patient define "Acute Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions": ( Common."Is Opioid Analgesic with Ambulatory Misuse Potential?"( ContextPrescriptions ) ) AmbulatoryOpioidPrescription where Routines."Is Acute Pain Prescription?"( AmbulatoryOpioidPrescription ) define "Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential": exists( "Chronic Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions" ) define "Is Recommendation Applicable?": "Inclusion Criteria" and not "Exclusion Criteria" define "Inclusion Criteria": "Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential" and Routines."Is Opioid Review Useful?" and Routines."Is Opioid Naive?" define "Exclusion Criteria": false define "Get Indicator": if "Is Recommendation Applicable?" then 'warning' else null define "Get Summary": if "Is Recommendation Applicable?" // NOTE: Wordsmithing here then 'Recommend use of nonpharmacologic therapy and nonopioid pharmacologic therapy as alternative' else null define "Get Detail": if "Is Recommendation Applicable?" then 'Medication requests(s): ' + Combine( flatten( Common.GetMedicationNames( "Chronic Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions" ) ), ', ' ) else null
Library - Recommendation #1 - Nonpharmacologic and Nonopioid Pharmacologic Therapy Consideration
Centers for Disease Control and Prevention (CDC)
Value set Opioid analgesics with ambulatory misuse potential
Acute Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions
Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential