opioidcds-09
type: PlanDefinition
node role: treeRoot
id:
  v: opioidcds-09
meta:
  profile:
    v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition
    l: cpg-recommendationdefinition
  profile:
    v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-publishableplandefinition
    l: cpg-publishableplandefinition
text:
  status:
    v: extensions
  div:
    v: Id: opioidcds-09 Url: Recommendation #9 - Consider Patient's History of Controlled Substance Prescriptions Version: 2022.1.0 Identifier: value: cdc-opioid-guidance Name: PlanDefinition_Recommendation_09_Order_Sign Title: Recommendation #9 - Consider Patient's History of Controlled Substance Prescriptions Status: draft Experimental: true Type: system: http://terminology.hl7.org/CodeSystem/plan-definition-type code: eca-rule display: ECA Rule Date: 2024-11-19 Publisher: Centers for Disease Control and Prevention (CDC) Description: When prescribing initial opioid therapy for acute, subacute, or chronic pain, and periodically during opioid therapy for chronic pain, clinicians should review the patient's history of controlled substance prescriptions using state prescription drug monitoring program (PDMP) data to determine whether the patient is receiving opioid dosages or combinations that put the patient at high risk for overdose. Logic Definitions: Library Name Name sequence OpioidCDSREC09 Chronic Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions 0 define &quot;Chronic Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions&quot;: ( Common.&quot;Is Opioid Analgesic with Ambulatory Misuse Potential?&quot;( ContextPrescriptions ) ) AmbulatoryOpioidPrescription where Routines.&quot;Is Subacute or Chronic Pain Prescription?&quot;( AmbulatoryOpioidPrescription ) Library Name Name sequence OpioidCDSREC09 Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential 1 define &quot;Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential&quot;: exists( &quot;Chronic Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions&quot; ) Library Name Name sequence OpioidCDSRoutines Patient Age Less Than 18 2 define &quot;Patient Age Less Than 18&quot;: if (Config.&quot;Age Less than 18 Years Is Enabled&quot;) then AgeInYearsAt(Today()) &lt; 18 else false Library Name Name sequence OpioidCDSRoutines Condit…
contained: Library
  id:
    v: effective-data-requirements
  status:
    v: active
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/library-type
        l: library-type
      code:
        v: module-definition
  related artifact:
    type:
      v: depends-on
    display:
      v: Library Common
    resource:
      v: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommon|2022.1.0
      l: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommon
  related artifact:
    type:
      v: depends-on
    display:
      v: Library FHIRHelpers
    resource:
      v: http://fhir.org/guides/cdc/opioid-cds/Library/FHIRHelpers|4.0.1
      l: http://fhir.org/guides/cdc/opioid-cds/Library/FHIRHelpers
  related artifact:
    type:
      v: depends-on
    display:
      v: Library Routines
    resource:
      v: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSRoutines|2022.1.0
      l: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSRoutines
  related artifact:
    type:
      v: depends-on
    display:
      v: Library Config
    resource:
      v: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommonConfig|2022.1.0
      l: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommonConfig
  related artifact:
    type:
      v: depends-on
    display:
      v: Value set Opioid analgesics with ambulatory misuse potential
    resource:
      v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-analgesics-with-ambulatory-misuse-potential
      l: opioid-analgesics-with-ambulatory-misuse-potential
  related artifact:
    type:
      v: depends-on
    display:
      v: Value set Community
    resource:
      v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/medicationrequest-category-community
      l: medicationrequest-category-community
  related artifact:
    type:
      v: depends-on
    display:
      v: Value set Encounter Diagnosis Condition Category
    resource:
      v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-encounter-diagnosis-category
      l: condition-encounter-diagnosis-category
  related artifact:
    type:
      v: depends-on
    display:
      v: Value set Problem List Condition Category
    resource:
      v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-problem-list-category
      l: condition-problem-list-category
  related artifact:
    type:
      v: depends-on
    display:
      v: Value set US Core Health Concern Condition Category
    resource:
      v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category
      l: condition-us-core-health-concern-category
  related artifact:
    type:
      v: depends-on
    display:
      v: Value set Limited life expectancy conditions
    resource:
      v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/limited-life-expectancy-conditions
      l: limited-life-expectancy-conditions
  related artifact:
    type:
      v: depends-on
    display:
      v: Value set Active Condition
    resource:
      v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-clinical-status-active
      l: condition-clinical-status-active
  related artifact:
    type:
      v: depends-on
    display:
      v: Value set PDMP review procedure
    resource:
      v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/pdmp-review-procedure
      l: pdmp-review-procedure
  related artifact:
    type:
      v: depends-on
    display:
      v: Value set PDMP data reviewed finding
    resource:
      v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/pdmp-data-reviewed-finding
      l: pdmp-data-reviewed-finding
  parameter:
    name:
      v: ContextPrescriptions
    use:
      v: in
    min:
      v: 0
    max:
      v: *
    type:
      v: MedicationRequest
  parameter:
    name:
      v: Is Recommendation Applicable?
    use:
      v: out
    min:
      v: 0
    max:
      v: 1
    type:
      v: boolean
  data requirement:
    type:
      v: Condition
    profile:
      v: http://hl7.org/fhir/StructureDefinition/Condition
      l: Condition
    must support:
      v: category
    code filter:
      path:
        v: category
      value set:
        v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-encounter-diagnosis-category
        l: condition-encounter-diagnosis-category
  data requirement:
    type:
      v: Condition
    profile:
      v: http://hl7.org/fhir/StructureDefinition/Condition
      l: Condition
    must support:
      v: category
    code filter:
      path:
        v: category
      value set:
        v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-problem-list-category
        l: condition-problem-list-category
  data requirement:
    type:
      v: Condition
    profile:
      v: http://hl7.org/fhir/StructureDefinition/Condition
      l: Condition
    must support:
      v: category
    code filter:
      path:
        v: category
      value set:
        v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category
        l: condition-us-core-health-concern-category
  data requirement:
    type:
      v: Procedure
    profile:
      v: http://hl7.org/fhir/StructureDefinition/Procedure
      l: Procedure

v: code

v: status

v: performed

path:
  v: code
value set:
  v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/pdmp-review-procedure
  l: pdmp-review-procedure

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/StructureDefinition/Observation
  l: Observation
must support:
  v: code
must support:
  v: status
code filter:
  path:
    v: code
  value set:
    v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/pdmp-data-reviewed-finding
    l: pdmp-data-reviewed-finding

url:
  v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
  l: cpg-knowledgeCapability
value: Code
  v: shareable

url:
  v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
  l: cpg-knowledgeCapability
value: Code
  v: computable

url:
  v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
  l: cpg-knowledgeCapability
value: Code
  v: executable

url:
  v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
  l: cpg-knowledgeCapability
value: Code
  v: publishable

url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem
  l: cqfm-softwaresystem
value: Reference
  l: cqf-tooling
  reference:
    v: Device/cqf-tooling

id:
  v: effective-data-requirements
url:
  v: http://fhir.org/guides/cdc/opioid-cds/StructureDefinition/effectiveDataRequirements
  l: effectiveDataRequirements
value: Reference
  l: effective-data-requirements
  reference:
    v: #effective-data-requirements

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSREC09
extension:
  url:
    v: name
    l: name
  value: String
    v: Chronic Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Chronic Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions": ( Common."Is Opioid Analgesic with Ambulatory Misuse Potential?"( ContextPrescriptions ) ) AmbulatoryOpioidPrescription where Routines."Is Subacute or Chronic Pain Prescription?"( AmbulatoryOpioidPrescription )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 0
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSREC09
extension:
  url:
    v: name
    l: name
  value: String
    v: Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential": exists( "Chronic Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 1
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Patient Age Less Than 18
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Patient Age Less Than 18": if (Config."Age Less than 18 Years Is Enabled") then AgeInYearsAt(Today()) < 18 else false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 2
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Condition Positive for Sickle Cell
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Condition Positive for Sickle Cell": if (Config."Sickle Cell Check Enabled") then exists( Common."Positive Sickle Cell Condition" ) else false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 3
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: US Core-Categorized Conditions
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // 3. Medications indicating end of life /* or exists ( "Medications Indicating End of Life" ) */ define "US Core-Categorized Conditions": [Condition: category in "Encounter Diagnosis Condition Category"] union [Condition: category in "Problem List Condition Category"] union [Condition: category in "US Core Health Concern Condition Category"]
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 4
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Conditions Indicating End Of Life Present
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Conditions Indicating End Of Life Present": exists ( Common."US Core-Categorized Conditions" LLEC where LLEC.code in Common."Limited life expectancy conditions" and LLEC.clinicalStatus in Common."Active Condition" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 5
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Active Cancer Treatment?
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Is Active Cancer Treatment?": if (Config."Active Cancer Treatment Encounters Condition Is Enabled") then "Has Two or More Encounters with Cancer Diagnosis During Encounter Period" else false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 6
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Conditions Including Cancer To Exclude Opioid Management Indicating End-Stage Disease Present
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Conditions Including Cancer To Exclude Opioid Management Indicating End-Stage Disease Present": if (Config."End-Stage Disease Criteria Enabled") then exists ( Common."US Core-Categorized Conditions" EOLC where EOLC.code in Common."Conditions likely terminal for opioid prescribing" and EOLC.clinicalStatus in Common."Active Condition" ) else false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 7
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Opioid Review Useful?
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Is Opioid Review Useful?": not "Patient Age Less Than 18" and not "Condition Positive for Sickle Cell" and not "Conditions Indicating End Of Life Present" and not "Is Active Cancer Treatment?" and not "Conditions Including Cancer To Exclude Opioid Management Indicating End-Stage Disease Present"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 8
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommonConfig
extension:
  url:
    v: name
    l: name
  value: String
    v: PDMP Data Not Reviewed in Past 90 Days Criteria Enabled
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // Recommendation 9 define "PDMP Data Not Reviewed in Past 90 Days Criteria Enabled": true
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 9
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSREC09
extension:
  url:
    v: name
    l: name
  value: String
    v: Look Back 90 Days
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Look Back 90 Days": Interval[Today() - 90 days, Today()]
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 10
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSREC09
extension:
  url:
    v: name
    l: name
  value: String
    v: PDMP Data Not Reviewed in Past 90 Days
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "PDMP Data Not Reviewed in Past 90 Days": Config."PDMP Data Not Reviewed in Past 90 Days Criteria Enabled" and not ( exists ( [Procedure: Common."PDMP review procedure"] P where P.status ~ 'completed' and P.performed during "Look Back 90 Days" ) or exists ( [Observation: Common."PDMP data reviewed finding"] O where O.status in { 'final', 'amended' } and ( if O.effective is FHIR.Period then (O.effective as FHIR.Period) during day of "Look Back 90 Days" else if O.effective is FHIR.dateTime then date from O.effective in day of "Look Back 90 Days" else false ) ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 11
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSREC09
extension:
  url:
    v: name
    l: name
  value: String
    v: Inclusion Criteria
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Inclusion Criteria": "Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential" and Routines."Is Opioid Review Useful?" and "PDMP Data Not Reviewed in Past 90 Days"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 12
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSREC09
extension:
  url:
    v: name
    l: name
  value: String
    v: Exclusion Criteria
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Exclusion Criteria": false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 13
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSREC09
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Recommendation Applicable?
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Is Recommendation Applicable?": "Inclusion Criteria" and not "Exclusion Criteria"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 14
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

id:
  v: effective-data-requirements
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements
  l: cqfm-effectiveDataRequirements
value: Reference
  l: effective-data-requirements
  reference:
    v: #effective-data-requirements

use:
  v: official
value:
  v: cdc-opioid-guidance

v: 2022.1.0

v: PlanDefinition_Recommendation_09_Order_Sign

v: Recommendation #9 - Consider Patient's History of Controlled Substance Prescriptions

coding:
  system:
    v: http://terminology.hl7.org/CodeSystem/plan-definition-type
    l: plan-definition-type
  code:
    v: eca-rule
  display:
    v: ECA Rule

v: draft

v: true

v: 2024-11-19

v: Centers for Disease Control and Prevention (CDC)

telecom:
  system:
    v: url
  value:
    v: https://www.cdc.gov

v: When prescribing initial opioid therapy for acute, subacute, or chronic pain, and periodically during opioid therapy for chronic pain, clinicians should review the patient's history of controlled substance prescriptions using state prescription drug monitoring program (PDMP) data to determine whether the patient is receiving opioid dosages or combinations that put the patient at high risk for overdose.

code:
  system:
    v: http://terminology.hl7.org/CodeSystem/usage-context-type
    l: usage-context-type
  code:
    v: focus
  display:
    v: Clinical Focus
value: CodeableConcept
  coding: http://snomed.info/id/182888003
    system:
      v: http://snomed.info/sct
      l: sct
    code:
      v: 182888003
    display:
      v: Medication requested (situation)

code:
  system:
    v: http://terminology.hl7.org/CodeSystem/usage-context-type
    l: usage-context-type
  code:
    v: focus
  display:
    v: Clinical Focus
value: CodeableConcept
  coding: http://snomed.info/id/82423001
    system:
      v: http://snomed.info/sct
      l: sct
    code:
      v: 82423001
    display:
      v: Chronic pain (finding)

code:
  system:
    v: http://terminology.hl7.org/CodeSystem/usage-context-type
    l: usage-context-type
  code:
    v: focus
  display:
    v: Clinical Focus
value: CodeableConcept
  coding: http://snomed.info/id/274663001
    system:
      v: http://snomed.info/sct
      l: sct
    code:
      v: 274663001
    display:
      v: Acute pain (finding)

code:
  system:
    v: http://terminology.hl7.org/CodeSystem/usage-context-type
    l: usage-context-type
  code:
    v: focus
  display:
    v: Clinical Focus
value: CodeableConcept
  text:
    v: Subacute pain

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.

v: At a minimum, during long-term opioid therapy, PDMP data should be reviewed before an initial opioid prescription and then every 3 months or more frequently.

v: © CDC 2016+.

text:
  v: Opioid Prescribing

name:
  v: Kensaku Kawamoto, MD, PhD, MHS

name:
  v: Bryn Rhodes

name:
  v: Floyd Eisenberg, MD, MPH

name:
  v: Robert McClure, MD, MPH

type:
  v: documentation
display:
  v: 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain
url:
  v: https://www.cdc.gov/mmwr/volumes/71/rr/pdfs/rr7103a1-H.pdf
  l: rr7103a1-H.pdf
document:
  content type:
    v: application/pdf
  language:
    v: en-US
  url:
    v: https://www.cdc.gov/mmwr/volumes/71/rr/pdfs/rr7103a1-H.pdf
    l: rr7103a1-H.pdf

title:
  v: Before Ordering Opioids, Review PDMP Data
description:
  v: Review PDMP data for this patient before completing an opioid order. For guidance about utilizing PDMP information to improve patient safety, see [Recommendation 9 of the 2022 CDC Clinical Practice Guideline](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#:~:text=Clinicians%20should%20take,see%20Recommendation%2010).). [CDC advises not to dismiss patients from your practice on the basis of PDMP information](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#:~:text=Clinicians%20should%20not%20dismiss,Recommendations%208%20and%2012%5D).)
priority:
  v: urgent
documentation:
  type:
    v: documentation
  url:
    v: https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#Recommendation9:~:text=risk%20for%20overdose-,(recommendation%20category%3A%20B%3B%20evidence%20type%3A%204).,-Implementation%20Considerations
    l: https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm
  document:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation
        l: cqf-strengthOfRecommendation
      value: CodeableConcept
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence
        l: cqf-qualityOfEvidence
      value: CodeableConcept
    url:
      v: https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#Recommendation9:~:text=risk%20for%20overdose-,(recommendation%20category%3A%20B%3B%20evidence%20type%3A%204).,-Implementation%20Considerations
      l: https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm
trigger:
  type:
    v: named-event
  name:
    v: order-sign
condition:
  kind:
    v: applicability
  expression:
    description:
      v: Check whether the current order is for an opioid with ambulatory misuse potential, if an opioid review is appropriate or there exists evidence of a prescription drug monitoring program (PDMP) review procedure or finding occurred in the past 90 days.
    language:
      v: text/cql.identifier
    expression:
      v: Is Recommendation Applicable?
grouping behavior:
  v: visual-group
selection behavior:
  v: any
action:
  description:
    v: Access Data - Launch app to review PDMP data
action:
  description:
    v: Document - PDMP data reviewed, snooze 3 months
action:
  description:
    v: Snooze* - N/A see comment, snooze 3 months

system:
  v: http://terminology.hl7.org/CodeSystem/recommendation-strength
  l: recommendation-strength
code:
  v: weak
display:
  v: Weak

system:
  v: http://terminology.hl7.org/CodeSystem/evidence-quality
  l: evidence-quality
code:
  v: very-low
display:
  v: Very low quality