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We sought to determine the incidence and predictors of aspirin discontinuation in veterans with LLE and\/or advanced dementia (LLE\/AD) who were taking aspirin for secondary prevention at nursing home admission, stratified by whether their limited prognosis (LP) was explicitly documented at admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>Retrospective cohort study using linked Veterans Affairs (VA) and Medicare clinical\/administrative data and Minimum Data Set resident assessments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>All VA nursing homes (referred to as community living centers [CLCs]) in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS<\/jats:title>\n                    <jats:p>Older (\u226565\u2009y) CLC residents with LLE\/AD, admitted for 7\u2009days or longer in fiscal years 2009 to 2015, who had a history of coronary artery disease and\/or stroke\/transient ischemic attack, and used aspirin within the first week of CLC admission (n = 13 844).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS<\/jats:title>\n                    <jats:p>The primary dependent variable was aspirin discontinuation within the first 90\u2009days after CLC admission, defined as 14 consecutive days of no aspirin receipt. Independent variables included an indicator for explicit documentation of LP, sociodemographics, environment of care characteristics, cardiovascular risk factors, bleeding risk factors, individual markers of poor prognosis (eg, cancer, weight loss), and facility characteristics. Fine and Gray subdistribution hazard models with death as a competing risk were used to assess predictors of discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Cumulative incidence of aspirin discontinuation was 27% (95% confidence interval [CI] = 26%\u201028%) in the full sample, 34% (95% CI = 33%\u201036%) in residents with explicit documentation of LP, and 24% (95% CI = 23%\u201025%) in residents with no such documentation. The associations of independent variables with aspirin discontinuation differed in residents with vs without explicit LP documentation at admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>\n                      Just over one\u2010quarter of patients discontinued aspirin, possibly reflecting the unclear role of aspirin in end of life among prescribers. Future research should compare outcomes of aspirin deprescribing in this population.\n                      <jats:bold>J Am Geriatr Soc 68:725\u2013735, 2020<\/jats:bold>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.16346","type":"journal-article","created":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T08:09:52Z","timestamp":1581581392000},"page":"725-735","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Incidence and Predictors of Aspirin Discontinuation in Older Adult Veteran Nursing Home Residents at End of Life"],"prefix":"10.1111","volume":"68","author":[{"given":"Sydney P.","family":"Springer","sequence":"first","affiliation":[{"name":"VA Pittsburgh Healthcare System, Center for Health Equity Research and Promotion  Pittsburgh Pennsylvania"},{"name":"Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy  Pittsburgh Pennsylvania"},{"name":"University of New England College of Pharmacy, Department of Pharmacy Practice  Portland ME"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria K.","family":"Mor","sequence":"additional","affiliation":[{"name":"VA Pittsburgh Healthcare System, Center for Health Equity Research and Promotion  Pittsburgh Pennsylvania"},{"name":"University of Pittsburgh School of Medicine, Division of General Internal Medicine  Pittsburgh PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florentina","family":"Sileanu","sequence":"additional","affiliation":[{"name":"VA Pittsburgh Healthcare System, Center for Health Equity Research and Promotion  Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinhua","family":"Zhao","sequence":"additional","affiliation":[{"name":"VA Pittsburgh Healthcare System, Center for Health Equity Research and Promotion  Pittsburgh Pennsylvania"},{"name":"University of Pittsburgh School of Medicine, Division of General Internal Medicine  Pittsburgh PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1342-6938","authenticated-orcid":false,"given":"Sherrie L.","family":"Aspinall","sequence":"additional","affiliation":[{"name":"VA Pittsburgh Healthcare System, Center for Health Equity Research and Promotion  Pittsburgh Pennsylvania"},{"name":"Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy  Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0520-311X","authenticated-orcid":false,"given":"Mary","family":"Ersek","sequence":"additional","affiliation":[{"name":"Corporal Michael J. Crescenz VA Medical Center, Center for Health Equity Research and Promotion  Philadelphia PA"},{"name":"University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences  Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1466-5751","authenticated-orcid":false,"given":"Joshua D.","family":"Niznik","sequence":"additional","affiliation":[{"name":"University of North Carolina School of Medicine, Division of Geriatric Medicine  Chapel Hill NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph T.","family":"Hanlon","sequence":"additional","affiliation":[{"name":"VA Pittsburgh Healthcare System, Center for Health Equity Research and Promotion  Pittsburgh Pennsylvania"},{"name":"University of Pittsburgh School of Medicine, Division of General Internal Medicine  Pittsburgh PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Hunnicutt","sequence":"additional","affiliation":[{"name":"VA Pittsburgh Healthcare System, Center for Health Equity Research and Promotion  Pittsburgh Pennsylvania"},{"name":"Division of Geriatric Medicine, University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walid F.","family":"Gellad","sequence":"additional","affiliation":[{"name":"VA Pittsburgh Healthcare System, Center for Health Equity Research and Promotion  Pittsburgh Pennsylvania"},{"name":"University of New England College of Pharmacy, Department of Pharmacy Practice  Portland ME"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loren J.","family":"Schleiden","sequence":"additional","affiliation":[{"name":"VA Pittsburgh Healthcare System, Center for Health Equity Research and Promotion  Pittsburgh Pennsylvania"},{"name":"Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy  Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua M.","family":"Thorpe","sequence":"additional","affiliation":[{"name":"VA Pittsburgh Healthcare System, Center for Health Equity Research and Promotion  Pittsburgh Pennsylvania"},{"name":"University of North Carolina Eshelman School of Pharmacy, Division of Pharmaceutical Outcomes and Policy  Chapel Hill NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn T.","family":"Thorpe","sequence":"additional","affiliation":[{"name":"VA Pittsburgh Healthcare System, Center for Health Equity Research and Promotion  Pittsburgh Pennsylvania"},{"name":"University of North Carolina Eshelman School of Pharmacy, Division of Pharmaceutical Outcomes and Policy  Chapel Hill NC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,2,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-S012"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2306"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000024"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2009.03.019"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000118288.04483.02"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2005.01477.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e3181f7d043"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.10.824"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2302"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.018"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2012.01.007"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2008.211"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1805819"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2017.12.006"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60503-1"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30770-5"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.6.605"},{"key":"e_1_2_6_19_1","unstructured":"IntratorO MakineniR CaiS MillerSC. 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