{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T16:16:26Z","timestamp":1776356186139,"version":"3.51.2"},"reference-count":37,"publisher":"American Society of Consultant Pharmacists","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["sr care pharm"],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:p><jats:bold>Background<\/jats:bold>In older inpatients, anticholinergic medications can increase the risk of complications that may increase length of stay (LOS). Cyclobenzaprine is an anticholinergic medication associated with mental status changes, falls, and injuries in older patients.<jats:bold>Objective<\/jats:bold>The purpose of this study is to determine whether use of a lower cyclobenzaprine dose (5 mg) compared with higher dosing (10 mg) will affect LOS, 30-day readmission rates, and need for injectable psychotropic agents in inpatients 65 years of age and older.<jats:bold>Methods<\/jats:bold>This was a retrospective cohort analysis comparing outcomes in patients 65 years of age and older who received either a 5 mg or 10 mg cyclobenzaprine dose during their inpatient admission over a 2.5-year period. The primary outcome was hospital LOS, adjusted using multivariate linear regression. Secondary outcomes included 30-day readmission rate adjusted using logistic regression and use of injectable antipsychotics or benzodiazepines. A sub-analysis evaluated the impact of the institution\u2019s implementation of a geriatric prescribing context (GEM-CON) on cyclobenzaprine dose selection.<jats:bold>Results<\/jats:bold>The adjusted LOS was 32.7% longer (95% CI 25.9%-39.9%) for patients exposed to higher-dose cyclobenzaprine. Use of injectable antipsychotics or benzodiazepines was also significantly greater in the higher-dose group (<jats:italic>P<\/jats:italic>&lt; 0.001;<jats:italic>P<\/jats:italic>= 0.025). Cyclobenzaprine dose was not significantly associated with readmission on multivariate analysis (OR = 0.93, 95% CI 0.45-1.93). After GEM-CON implementation, there was a significant increase in use of the recommended lower cyclobenzaprine dose (<jats:italic>P<\/jats:italic>&lt; 0.001).<jats:bold>Conclusion<\/jats:bold>Use of lower cyclobenzaprine dosing in older inpatients is associated with reduced hospital LOS and need for injectable antipsychotics and benzodiazepines.<\/jats:p>","DOI":"10.4140\/tcp.n.2024.249","type":"journal-article","created":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T04:30:28Z","timestamp":1719549028000},"page":"249-258","source":"Crossref","is-referenced-by-count":2,"title":["Utilization of Lower-Dose Cyclobenzaprine in the Older Inpatient"],"prefix":"10.4140","volume":"39","author":[{"given":"Katherine G.","family":"Coli","sequence":"first","affiliation":[{"name":"1 Upstate University Hospital, Pharmacy Department, Syracuse, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaylan M.","family":"Yuksel","sequence":"additional","affiliation":[{"name":"2 Upstate Community Hospital, Pharmacy Department, Syracuse, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth L.","family":"McCall","sequence":"additional","affiliation":[{"name":"3 Binghamton University School of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice, Johnson City, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiajie","family":"Guan","sequence":"additional","affiliation":[{"name":"2 Upstate Community Hospital, Pharmacy Department, Syracuse, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly R.","family":"Ulen","sequence":"additional","affiliation":[{"name":"2 Upstate Community Hospital, Pharmacy Department, Syracuse, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Noviasky","sequence":"additional","affiliation":[{"name":"2 Upstate Community Hospital, Pharmacy Department, Syracuse, New 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