opioidcds-01
type: PlanDefinition
node role: treeRoot
id:
  v: opioidcds-01
meta:
  profile:
    v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition
    link: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition
  profile:
    v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-publishableplandefinition
    link: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-publishableplandefinition
text:
  status:
    v: extensions
  div: Id: opioidcds-01 Url: Recommendation #1 - Nonpharmacologic and Nonopioid Pharmacologic Therapy Consideration Version: 2022.1.0 Identifier: value: cdc-opioid-guidance Name: PlanDefinition_Recommendation_01_Order_Sign Title: Recommendation #1 - Nonpharmacologic and Nonopioid Pharmacologic Therapy Consideration Status: draft Experimental: true Type: system: http://terminology.hl7.org/CodeSystem/plan-definition-type code: eca-rule display: ECA Rule Date: 2025-07-01 Publisher: Centers for Disease Control and Prevention (CDC) Description: Nonopioid therapies are at least as effective as opioids for many common types of acute pain. Clinicians should maximize use of nonpharmacologic and nonopioid pharmacologic therapies as appropriate for the specific condition and patient and only consider opioid therapy for acute pain if benefits are anticipated to outweigh risks to the patient. Before prescribing opioid therapy for acute pain, clinicians should discuss with patients the realistic benefits and known risks of opioid therapy. Logic Definitions: Library Name Name sequence OpioidCDSREC01 Acute Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions 0 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 ) Library Name Name sequence OpioidCDSREC01 Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential 1 define "Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential": exists( "Acute Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions" ) Library Name Name sequence OpioidCDSRoutines Patient Age Less Than 18 2 define "Patient Age Less Than 18": if (Config."Age Less than 18 Years Is Enabled") then AgeInYearsAt(Today()) < 18 else false Library Name Name sequence OpioidCDSRoutines Condit…
contained: Library
  id:
    v: effective-data-requirements
  name:
    v: EffectiveDataRequirements
  status:
    v: active
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/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
      link: 2022.1
      link: .0
  related artifact:
    type:
      v: depends-on
    display:
      v: Library FHIRHelpers
    resource:
      v: http://fhir.org/guides/cdc/opioid-cds/Library/FHIRHelpers|4.0.1
      link: 4.0
      link: .1
  related artifact:
    type:
      v: depends-on
    display:
      v: Library Routines
    resource:
      v: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSRoutines|2022.1.0
      link: 2022.1
      link: .0
  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
      link: http://fhir.org/guides/cdc/opioid-cds/ValueSet/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
      link: http://fhir.org/guides/cdc/opioid-cds/ValueSet/medicationrequest-category-community
  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
extension:
  url:
    v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
  value: code
    v: shareable
extension:
  url:
    v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
  value: code
    v: computable
extension:
  url:
    v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
  value: code
    v: executable
extension:
  url:
    v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
  value: code
    v: publishable
extension:
  extension:
    url:
      v: libraryName
    value: string
      v: OpioidCDSREC01
  extension:
    url:
      v: name
    value: string
      v: Acute Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions
  extension:
    url:
      v: statement
    value: string
      v: 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 )
  extension:
    url:
      v: displaySequence
    value: integer
      v: 0
  url:
    v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
extension:
  extension:
    url:
      v: libraryName
    value: string
      v: OpioidCDSREC01
  extension:
    url:
      v: name
    value: string
      v: Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential
  extension:
    url:
      v: statement
    value: string
      v: define "Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential": exists( "Acute Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions" )
  extension:
    url:
      v: displaySequence
    value: integer
      v: 1
  url:
    v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
extension:
  extension:
    url:
      v: libraryName
    value: string
      v: OpioidCDSRoutines
  extension:
    url:
      v: name
    value: string
      v: Patient Age Less Than 18
  extension:
    url:
      v: 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
    value: integer
      v: 2
  url:
    v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
extension:
  extension:
    url:
      v: libraryName
    value: string
      v: OpioidCDSRoutines
  extension:
    url:
      v: name
    value: string
      v: Condition Positive for Sickle Cell
  extension:
    url:
      v: 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
    value: integer
      v: 3

extension:
  url:
    v: libraryName
  value: string
    v: OpioidCDSRoutines
extension:
  url:
    v: name
  value: string
    v: Is Active Cancer Treatment?
extension:
  url:
    v: 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" or "Has Active Cancer Diagnosis on Problem List" else false
extension:
  url:
    v: displaySequence
  value: integer
    v: 4
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

extension:
  url:
    v: libraryName
  value: string
    v: OpioidCDSRoutines
extension:
  url:
    v: name
  value: string
    v: Conditions Likely Terminal for Opioid Prescribing
extension:
  url:
    v: statement
  value: string
    v: define "Conditions Likely Terminal for Opioid Prescribing": 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
  value: integer
    v: 5
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

extension:
  url:
    v: libraryName
  value: string
    v: OpioidCDSRoutines
extension:
  url:
    v: name
  value: string
    v: Is Opioid Review Useful?
extension:
  url:
    v: statement
  value: string
    v: define "Is Opioid Review Useful?": not "Patient Age Less Than 18" and not "Condition Positive for Sickle Cell" and not "Is Active Cancer Treatment?" and not "Conditions Likely Terminal for Opioid Prescribing"
extension:
  url:
    v: displaySequence
  value: integer
    v: 6
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

extension:
  url:
    v: libraryName
  value: string
    v: OpioidCDSRoutines
extension:
  url:
    v: name
  value: string
    v: Has Opioid RX with Ambulatory Abuse Potential In Past 90 Days
extension:
  url:
    v: statement
  value: string
    v: define "Has Opioid RX with Ambulatory Abuse Potential In Past 90 Days": if (Config."Opioid Naive Prescription Condition Is Enabled") then exists ("Opioid RX with Ambulatory Abuse Potential In Past 90 Days") else false
extension:
  url:
    v: displaySequence
  value: integer
    v: 7
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

extension:
  url:
    v: libraryName
  value: string
    v: OpioidCDSRoutines
extension:
  url:
    v: name
  value: string
    v: Has Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days
extension:
  url:
    v: statement
  value: string
    v: define "Has Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days": if (Config."Opioid Naive Prescription Condition Is Enabled") then exists ("Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days") else false
extension:
  url:
    v: displaySequence
  value: integer
    v: 8
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

extension:
  url:
    v: libraryName
  value: string
    v: OpioidCDSRoutines
extension:
  url:
    v: name
  value: string
    v: Is Opioid Naive?
extension:
  url:
    v: statement
  value: string
    v: // NOTE: MedicationStatement-dependent logic comment out due to bug in Publisher not supporting MedicationStatement in AllTypes. define "Is Opioid Naive?": not ("Has Opioid RX with Ambulatory Abuse Potential In Past 90 Days") /* and not ("Has Report of Opioid with Ambulatory Care Abuse Potential Reported in Past 90 Days") */ and not ("Has Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days")
extension:
  url:
    v: displaySequence
  value: integer
    v: 9
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

extension:
  url:
    v: libraryName
  value: string
    v: OpioidCDSREC01
extension:
  url:
    v: name
  value: string
    v: Inclusion Criteria
extension:
  url:
    v: statement
  value: string
    v: define "Inclusion Criteria": "Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential" and Routines."Is Opioid Review Useful?" and Routines."Is Opioid Naive?"
extension:
  url:
    v: displaySequence
  value: integer
    v: 10
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

extension:
  url:
    v: libraryName
  value: string
    v: OpioidCDSREC01
extension:
  url:
    v: name
  value: string
    v: Exclusion Criteria
extension:
  url:
    v: statement
  value: string
    v: define "Exclusion Criteria": false
extension:
  url:
    v: displaySequence
  value: integer
    v: 11
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

extension:
  url:
    v: libraryName
  value: string
    v: OpioidCDSREC01
extension:
  url:
    v: name
  value: string
    v: Is Recommendation Applicable?
extension:
  url:
    v: statement
  value: string
    v: define "Is Recommendation Applicable?": "Inclusion Criteria" and not "Exclusion Criteria"
extension:
  url:
    v: displaySequence
  value: integer
    v: 12
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

extension:
  url:
    v: libraryName
  value: string
    v: OpioidCDSCommon
extension:
  url:
    v: name
  value: string
    v: Is Opioid Analgesic with Ambulatory Misuse Potential?
extension:
  url:
    v: statement
  value: string
    v: define function "Is Opioid Analgesic with Ambulatory Misuse Potential?"(value List<MedicationRequest>): ("Get MedicationRequest Medication as Code"(value)) Rx where Rx.medication in "Opioid analgesics with ambulatory misuse potential" and Rx.category in "Community"
extension:
  url:
    v: displaySequence
  value: integer
    v: 13
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

extension:
  url:
    v: libraryName
  value: string
    v: OpioidCDSCommon
extension:
  url:
    v: name
  value: string
    v: Get MedicationRequest Medication as Code
extension:
  url:
    v: statement
  value: string
    v: define function "Get MedicationRequest Medication as Code"(value List<MedicationRequest>): value Rx let Med: if Rx.medication is Reference then singleton from ( [Medication] M where M.id = (Last(Split((Rx.medication as FHIR.Reference).reference, '/'))) ) else null return MedicationRequest { id: Rx.id, status: Rx.status, intent: Rx.intent, category: Rx.category, medication: if Rx.medication is Reference then Med.code else Rx.medication as CodeableConcept, subject: Rx.subject, authoredOn: Rx.authoredOn, recorder: Rx.recorder, dosageInstruction: Rx.dosageInstruction, dispenseRequest: Rx.dispenseRequest }
extension:
  url:
    v: displaySequence
  value: integer
    v: 14
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

extension:
  url:
    v: libraryName
  value: string
    v: FHIRHelpers
extension:
  url:
    v: name
  value: string
    v: ToConcept
extension:
  url:
    v: statement
  value: string
    v: define function ToConcept(concept FHIR.CodeableConcept): if concept is null then null else System.Concept { codes: concept.coding C return ToCode(C), display: concept.text.value }
extension:
  url:
    v: displaySequence
  value: integer
    v: 15
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

extension:
  url:
    v: libraryName
  value: string
    v: OpioidCDSRoutines
extension:
  url:
    v: name
  value: string
    v: Is Acute Pain Prescription?
extension:
  url:
    v: statement
  value: string
    v: // End of For Subacute or Chronic Pain Routine /* ** Routine #5 ** For Acute Pain Routine ** ** Definition | Answer to Proceed | Details | Data (Terminology) Requirement ** ----------------------------------------------------------------------------------------------------------------------------------- ** Order for opioid analgesics | Yes | Look for an existing prescription (order) for | Opioid analgesics with ** with ambulatory misuse | | opioid analgesics with ambulatory abuse | ambulatory misuse potential ** potential of duration < 28 | | potential of duration < 28 days | ** days | | | ** ----------------------------------------------------------------------------------------------------------------------------------- ** */ // should allow DateTime precision, but not working in the Ruler specifically define function "Is Acute Pain Prescription?"(prescription FHIR.MedicationRequest): prescription.dispenseRequest is not null and prescription.dispenseRequest.expectedSupplyDuration is not null and Common.GetDurationInDays( prescription.dispenseRequest.expectedSupplyDuration ) < 28 days
extension:
  url:
    v: displaySequence
  value: integer
    v: 16
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

extension:
  url:
    v: libraryName
  value: string
    v: OpioidCDSCommon
extension:
  url:
    v: name
  value: string
    v: GetDurationInDays
extension:
  url:
    v: statement
  value: string
    v: define function GetDurationInDays(value FHIR.Duration): if value is null then null else case when value.code.value ~ 'a' then System.Quantity{ value: value.value.value * 365.0, unit: 'days' } when value.code.value ~ 'mo' then System.Quantity{ value: value.value.value * 30.0, unit: 'days' } when value.code.value ~ 'wk' then System.Quantity{ value: value.value.value * 7.0, unit: 'days' } when value.code.value ~ 'd' then System.Quantity{ value: value.value.value, unit: 'days' } when value.code.value ~ 'h' then System.Quantity{ value: value.value.value / 24.0, unit: 'days' } when value.code.value ~ 'min' then System.Quantity{ value: value.value.value / 60.0 / 24.0, unit: 'days' } when value.code.value ~ 's' then System.Quantity{ value: value.value.value / 60.0 / 60.0 / 24.0, unit: 'days' } when value.code.value ~ 'ms' then System.Quantity{ value: value.value.value / 60.0 / 60.0 / 24.0 / 1000.0, unit: 'days' } when value.code.value is null then Message(1000, true, 'Undefined', 'Error', 'Duration unit code is null') else Message(1000, true, 'Undefined', 'Error', 'Unsupported duration unit code: ' + value.code.value) end
extension:
  url:
    v: displaySequence
  value: integer
    v: 17
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

id:
  v: effective-data-requirements
url:
  v: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
value: canonical
  v: #effective-data-requirements

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

v: 2022.1.0

v: PlanDefinition_Recommendation_01_Order_Sign

v: Recommendation #1 - Nonpharmacologic and Nonopioid Pharmacologic Therapy Consideration

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

v: draft

v: true

v: 2025-07-01

v: Centers for Disease Control and Prevention (CDC)

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

v: Nonopioid therapies are at least as effective as opioids for many common types of acute pain. Clinicians should maximize use of nonpharmacologic and nonopioid pharmacologic therapies as appropriate for the specific condition and patient and only consider opioid therapy for acute pain if benefits are anticipated to outweigh risks to the patient. Before prescribing opioid therapy for acute pain, clinicians should discuss with patients the realistic benefits and known risks of opioid therapy.

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

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

v: The 2022 CDC Clinical Practice Guideline for Prescribing Opioids for 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.

v: Clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient.

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/rr7103a1.htm
document:
  url:
    v: https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation
  value: CodeableConcept
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/recommendation-strength
      code:
        v: weak
      display:
        v: Weak
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence
  value: CodeableConcept
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/evidence-quality
      code:
        v: low
      display:
        v: Low quality
title:
  v: Consider Nonopioid Treatment Options for Acute Pain
description:
  v: For many types of acute pain, clinicians should maximize the use of nonpharmacologic (for example, physical therapy) and nonopioid pharmacologic therapies (for example, NSAIDs), as appropriate for the specific condition and patient and only consider opioid therapy for acute pain if benefits are anticipated to outweigh risks to the patient. Before prescribing opioid therapy for acute pain, clinicians should discuss with patients the realistic benefits and known risks of opioid therapy. [Recommendation 1 of the 2022 CDC Clinical Practice Guideline](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#Recommendation1) provides nonopioid therapy options for common acute pain conditions. **Nonopioid Pharmacological Therapy** - [Dental pain (acute)](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#:~:text=The%20American%20Dental%20Association%20(ADA)%20recommends%20NSAIDs%20as%20first%2Dline%20treatment%20for%20acute%20dental%20pain%20management) - [Dental pain (surgical)](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#:~:text=NSAIDs%20have%20been%20found%20to%20be%20more%20effective%20than%20opioids%20for%20surgical%20dental%20pain) - [Kidney stone pain (acute)](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#:~:text=For%20acute%20kidney%20stone%20pain%2C%20NSAIDs%20are%20at%20least%20as%20effective%20as%20opioids%20(124%E2%80%93127)%2C%20can%20decrease%20the%20ureteral%20smooth%20muscle%20tone%20and%20ureteral%20spasm%20(128)%20causing%20kidney%20stone%20pain%2C%20and%20are%20preferred%20for%20kidney%20stone%20pain%20if%20not%20contraindicated.) - [Low back pain (acute)](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#:~:text=NSAIDs%20have%20been%20found%20to%20be%20more%20effective%20than%20opioids%20for%20surgical%20dental%20pain%20and%20kidney%20stone%20pain%20and%20similarly%20effective%20to%20opioids%20for%20low%20back%20pain) - [Migraine pain (episodic)](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#:~:text=For%20episodic%20migraine%2C%20tript…
priority:
  v: urgent
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, the patient is opioid naive and if an opioid review is appropriate for the patient
    language:
      v: text/cql.identifier
    expression:
      v: Is Recommendation Applicable?
grouping behavior:
  v: visual-group
selection behavior:
  v: any
action:
  description:
    v: Document - Record reason for opioid therapy
action:
  description:
    v: Snooze* - Attempt alternative therapy, snooze 3 months
action:
  description:
    v: Order - Select alternative therapies from order set
action:
  description:
    v: Snooze* - N/A see comment, snooze 3 months
action:
  description:
    v: Remove - Will remove triggering medication order