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Example PlanDefinition/opioidcds-05 (Narrative)

Clinical Decision Support Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: No defined compartments

This is the narrative for the resource. See also the XML, JSON or Turtle format. This example conforms to the profile PlanDefinition.

Generated Narrative: PlanDefinition

Resource PlanDefinition "opioidcds-05"

StructureDefinition Work Group: cds

identifier: URI/urn:oid:2.16.840.1.113883.4.642.11.1, cdc-opioid-guidance (use: OFFICIAL)

version: 0.1.0

name: Cdcopioid05

title: CDC Opioid Prescribing Guideline Recommendation #5

type: ECA Rule (PlanDefinitionType#eca-rule)

status: draft

date: 2017-04-23

publisher: HL7 International / Clinical Decision Support


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


*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: United States of America (ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code#US)

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:


type: documentation

display: CDC guideline for prescribing opioids for chronic pain



type: documentation

display: MME Conversion Tables


library: http://example.org/fhir/Library/opioidcds-recommendation-05


Strength of recommendation: Strong (StrengthOfRecommendationRating#strong)

Quality of evidence: Low quality (QualityOfEvidenceRating#low)

title: High risk for opioid overdose.

description: Total morphine milligram equivalent (MME) exceeds recommended amount. Taper to less than 50.






kind: applicability


*Is total MME >= 50?text/cqlIs MME 50 Or More?

groupingBehavior: visual-group

selectionBehavior: exactly-one


path: action.title




path: action.description




path: activity.extension




*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



Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.