Your browser doesn't support javascript.
loading
Utilization of Lower-Dose Cyclobenzaprine in the Older Inpatient.
Coli, Katherine G; Yuksel, Jaylan M; McCall, Kenneth L; Guan, Jiajie; Ulen, Kelly R; Noviasky, John.
Afiliación
  • Coli KG; 1 Upstate University Hospital, Pharmacy Department, Syracuse, New York.
  • Yuksel JM; 2 Upstate Community Hospital, Pharmacy Department, Syracuse, New York.
  • McCall KL; 3 Binghamton University School of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice, Johnson City, New York.
  • Guan J; 2 Upstate Community Hospital, Pharmacy Department, Syracuse, New York.
  • Ulen KR; 2 Upstate Community Hospital, Pharmacy Department, Syracuse, New York.
  • Noviasky J; 2 Upstate Community Hospital, Pharmacy Department, Syracuse, New York.
Sr Care Pharm ; 39(7): 249-258, 2024 Jul 01.
Article en En | MEDLINE | ID: mdl-38937891
ABSTRACT
Background 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. Objective 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. Methods 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's implementation of a geriatric prescribing context (GEM-CON) on cyclobenzaprine dose selection. Results 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 (P < 0.001; P = 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 (P < 0.001). Conclusion Use of lower cyclobenzaprine dosing in older inpatients is associated with reduced hospital LOS and need for injectable antipsychotics and benzodiazepines.
Asunto(s)
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Readmisión del Paciente / Relación Dosis-Respuesta a Droga / Amitriptilina / Tiempo de Internación Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Sr Care Pharm Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Readmisión del Paciente / Relación Dosis-Respuesta a Droga / Amitriptilina / Tiempo de Internación Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Sr Care Pharm Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos