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cds.ahrq.gov/taxonomy/term/14896
November 02, 2018 - Search All AHRQ Sites
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cds.ahrq.gov/cdsconnect/artifact/recommendation-11-concurrent-use-opioids-and-benzodiazepines
September 27, 2018 - Search All AHRQ Sites
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cds.ahrq.gov/sites/default/files/cds/artifact/136331/Benzodiazepine%20Patient%20Handout.pdf
January 01, 2018 - PowerPoint - Updated Handouts - Read-Only
REDUCING MEDICATIONS SAFELY
TO MEET LIFE’S CHANGES
FOCUS ON BENZODIAZEPINE … RECEPTOR AGONISTS (BZRAs)FOCUS ON BENZODIAZEPINE RECEPTOR AGONISTS & Z-DRUGS (BZRAs)
As life changes … Evidence-based clinical
practice guideline for deprescribing benzodiazepine receptor agonists. … Adapted from “Reducing Medications Safely to Meet Life’s Changes, Focus on Benzodiazepine Receptor Agonists
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cds.ahrq.gov/sites/default/files/cds/artifact/476/Pilot%20Site%20Training%20for%20Pain%20Management%20Summary%20CDS%20for%20Repository.pdf
May 24, 2023 - preferred
– ≥90 MME/day is high risk
§ Urine drug screening (prior to and annually)
§ Avoid concurrent benzodiazepines … Assessments
§ MME amount - most recent
§ Urine drug screen results – all within the past 1 year
§ Benzodiazepine … ”
§ Benzodiazepine Medications
– Elements: Benzodiazepine medication statements and orders.
– Flag … if there is at least one benzodiazepine medication and at least one opioid medication:
“Benzodiazepine … ”
– Flag if there is at least one benzodiazepine medication: “Evidence of a benzodiazepine medication
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cds.ahrq.gov/sites/default/files/cds/artifact/476/Pilot%20Site%20Training%20for%20Pain%20Management%20Summary%20CDS_for%20Repository.pdf
September 21, 2018 - preferred
– ≥90 MME/day is high risk
▪ Urine drug screening (prior to and annually)
▪ Avoid concurrent benzodiazepines … – Stool softeners and laxatives
Risk Considerations
– MME amount
– Urine drug screen results
– Benzodiazepine … ”
▪ Benzodiazepine Medications
– Elements: Benzodiazepine medication statements and orders. … – Flag if there is at least one benzodiazepine medication and at least one opioid medication:
“Benzodiazepine … ”
– Flag if there is at least one benzodiazepine medication: “Evidence of a benzodiazepine medication
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cds.ahrq.gov/sites/default/files/cds/artifact/476/CDS%20Pain%20Management%20Summary%20Quick%20Start%20Guide_final.pdf
June 14, 2018 - Recent MME – amount and date (most recent)
Urine Drug Screens – date and result (1-year lookback)
Benzodiazepine … to 50
Urine Drug Screens: Flag if not present AND at least one opioid
medication is present
Benzodiazepine
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cds.ahrq.gov/sites/default/files/cds/artifact/476/2023_CDS_Connect_IG_Pain_Management_Summary.pdf
January 01, 2023 - • Recommendation 11: Clinicians should avoid prescribing opioid pain medication and
benzodiazepines … Benzodiazepine medications ordered or recorded for the patient within the last 2
years, including the … Concepts in this category include MME amount, urine drug screen results,
evidence of benzodiazepine … Intervention “Benzodiazepine
medications”
Per CDC guideline information and U.S. … The CQL looks back
2 years for evidence of a benzodiazepine to provide historical perspective.
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cds.ahrq.gov/sites/default/files/cds/artifact/476/Pain%20Management%20Summary%20Clincial%20Decision%20Support%20Toolkit_for%20Repository.xlsx
January 01, 2003 - (active), pregnancy (active) and suicide attempt (resolved)
Medication List: contains qualifying - benzodiazepine … suicide attempt and pregnancy noted dates (from PL)
Risk Screenings:
SASQ score and date recorded
Benzodiazepine … Medications:
contains qualifying benzodiazepine medication
Numeric Pain Intensity Assessments:
Wong … Medications is viewed Hover text displays: "Benzodiazepine medication and at least one … Medications is viewed Hover text displays: "Evidence of a benzodiazepine medication"
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cds.ahrq.gov/sites/default/files/cds/artifact/476/Implementation_Guide_Pain_Management_Summary_1.pdf
September 01, 2022 - • Recommendation 11: Clinicians should avoid prescribing opioid pain medication and
benzodiazepines … Benzodiazepine medications ordered or recorded for the patient within the last 2
years, including the … Concepts in this category include: MME amount, urine drug screen results,
evidence of benzodiazepine … Intervention “Benzodiazepine
medications”
Per CDC guideline information and U.S. … The CQL looks back 2
years for evidence of a benzodiazepine to provide historical perspective.
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cds.ahrq.gov/sites/default/files/cds/artifact/476/ImplementationGuidePainManagementSummary50810012018.pdf
December 01, 2018 - • Recommendation #11: Clinicians should avoid prescribing opioid pain medication and
benzodiazepines … Benzodiazepine medications ordered or recorded for the patient within the last
2 years, including the … date in past 6 months)
Urine drug screen (verified, result, interpretation, date in past 1 year)
Benzodiazepines … Intervention “Benzodiazepine
medications”
Per CDC guideline information and U.S. … The CQL looks back 2 years for evidence of a
benzodiazepine to provide historical perspective.
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cds.ahrq.gov/sites/default/files/cds/artifact/476/ImplementationGuidePainManagementSummary508_with%202020%20updates%202.pdf
May 01, 2020 - • Recommendation #11: Clinicians should avoid prescribing opioid pain medication and
benzodiazepines … Benzodiazepine medications ordered or recorded for the patient within the last
2 years, including the … Concepts in this category include: MME
amount, urine drug screen results, evidence of benzodiazepine … Intervention “Benzodiazepine
medications”
Per CDC guideline information and U.S. … The CQL looks back 2 years for evidence of a
benzodiazepine to provide historical perspective.
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cds.ahrq.gov/sites/default/files/cds/artifact/476/Implementation_Guide_Pain_Management_Summary.pdf
September 01, 2021 - • Recommendation 11: Clinicians should avoid prescribing opioid pain medication and
benzodiazepines … Benzodiazepine medications ordered or recorded for the patient within the last
two years, including … Concepts in this category include: MME amount, urine
drug screen results, evidence of benzodiazepine … Food and Drug Administration guidance, opioids
should not be prescribed if a patient is on a benzodiazepine … The CQL looks back 2 years for evidence of a benzodiazepine to provide
historical perspective.
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cds.ahrq.gov/sites/default/files/reports/CDS_Connect_Pain_Management_Environmental_Scan.pdf
December 01, 2017 - are directed at reducing opioid exposure in prescriptions: reducing the
prescription of opioids and benzodiazepines … recommending
avoidance when possible; provides alerts for concomitant prescribing of opioids and
benzodiazepines … alert for large daily doses, large total prescribed amounts, and combined
prescribing of opioids with benzodiazepines … quantities greater than 200 pills; a 90% decrease in the combination
of an opioid prescription with benzodiazepines … Reminder/
Order
Consider naloxone
Trigger: If on OT and >50
MME/day, concurrent use of
benzodiazepines
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cds.ahrq.gov/sites/default/files/cds/artifact/476/EnhancementofCDSArtifact%20BasedonPilotImplementation10012018.pdf
December 01, 2018 - in past 6 months)
• Urine drug screen (verified, result, interpretation, date in past 1 year)
• Benzodiazepines … in past 6 months)
• Urine drug screen (verified, result, interpretation, date in past 1 year)
• Benzodiazepines
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cds.ahrq.gov/sites/default/files/AHRQ_Final_Report_2019.pdf
January 01, 2019 - - Urine Drug Testing CDC Structured 04/23/2017
Recommendation #11: Concurrent Use of Opioids
and Benzodiazepines … urine-drug-testing
https://cds.ahrq.gov/cdsconnect/artifact/recommendation-11-concurrent-use-opioids-and-benzodiazepines … https://cds.ahrq.gov/cdsconnect/artifact/recommendation-11-concurrent-use-opioids-and-benzodiazepines
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cds.ahrq.gov/sites/default/files/cds/artifact/476/CDSConnectPilotFinalReport508gel10012018.pdf
September 01, 2018 - • Benzodiazepine Medications Flag if present AND at least one opioid medication; Flag if
present
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cds.ahrq.gov/sites/default/files/reports/AHRQ_Final_Report_2018.pdf
January 01, 2018 - date in past 6 months)
Urine drug screen (verified, result, interpretation, date in past 1 year)
Benzodiazepine