Id: library-OpioidCDSREC10 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 Data Requirements: type: Observation code filter: path: code valueset: http://fhir.org/guides/cdc/opioid-cds/ValueSet/non-opioid-drug-urine-screening type: Observation code filter: path: code valueset: http://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-drug-urine-screening Content: type: text/cql library OpioidCDSREC10 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 #10 ** When prescribing opioids for subacute or chronic pain, providers should use urine drug ** testing before starting opioid therapy and consider urine drug testing at ** least annually to assess for prescribed medications as well as other controlled ** prescription drugs and illicit drugs (recommendation category: B, evidence type: 4) ** ** When ** Provider is prescribing an opioid analgesic with ambulatory misuse potential in the outpatient setting ** Prescription is for treating chronic pain. ** 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 ** Urine drug screening has not been performed in last 12 months ** Then ** Recommend urine drug screening ** Will perform urine screening ** Not for chronic pain management, snooze 3 months ** N/A - see comment, snooze 3 months ** */ // META: Plan Definition: http://fhir.org/guides/cdc/opioid-cds-r4/PlanDefinition/opioid-cds-10 parameter ContextPrescriptions List<MedicationRequest> context Patient define "Lookback Year": Interval[Today() - 12 months - 1 days, Today() - 1 day] define "Chronic 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 not "Patient had Urine Screening in Last 12 Months" define "Exclusion Criteria": Common."End of Life Assessment" define "Patient had Urine Screening in Last 12 Months": exists( "Urine Screenings during the Last 12 Months" ) define "Urine Screenings during the Last 12 Months": ( [Observation: "code" in Common."Non-opioid drug urine screening"] IllicitDrugScreen where date from IllicitDrugScreen.effective in day of "Lookback Year" ) union ( [Observation: "code" in Common."Opioid drug urine screening"] OpioidDrugScreen where date from OpioidDrugScreen.effective in day of "Lookback Year" ) define "No Screening In Last 12 Months Indicator": if "Is Recommendation Applicable?" then 'warning' else null define "No Screening In Last 12 Months Summary": if "Is Recommendation Applicable?" then 'Annual Urine Screening Check' else null define "No Screening In Last 12 Months Detail": if "Is Recommendation Applicable?" then 'Patients on opioid therapy should have a urine drug test performed every 12 months.' else null
Library - Recommendation #10 - Urine Drug Testing
Centers for Disease Control and Prevention (CDC)
Value set Opioid analgesics with ambulatory misuse potential
Subacute or Chronic Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions
Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential
Is Perform Drug Screen Recommendation Applicable?
Applicable Because of Unexpected Results