{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T06:02:03Z","timestamp":1780034523999,"version":"3.53.1"},"reference-count":49,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["IIR 19\u2010106"],"award-info":[{"award-number":["IIR 19\u2010106"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Discontinuation of medications with limited benefits (LBM) in patients nearing the end of life can reduce burden, adverse events, and costs, and enhance quality of life. However, most research on end\u2010of\u2010life prescribing has focused on nursing homes or hospice settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To describe the prevalence of LBM use and discontinuation or deintensification over the last year of life in community\u2010dwelling older veterans with advanced life\u2010limiting conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective, national cohort study of U.S. veteran decedents (\u2265\u200965\u2009years) with advanced life\u2010limiting conditions who died between October 2016 and September 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Community\u2010residing, non\u2010hospice older veterans. LBM users were identified using consensus\u2010based criteria and assessed for discontinuation over the last year of life. We estimated LBM discontinuation rate ratios using multivariable robust Poisson regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 37,193 decedents (mean age 78\u2009years), 73% were on at least one LBM (e.g., statins, oral antidiabetics, antihypertensives, antithrombotics, anti\u2010ulcer, or antidementia drugs) entering the last year (baseline). Of these baseline LBM users, 22.0% experienced at least one LBM discontinuation over their final year. Veterans residing in more rural counties had lower LBM discontinuation rates than those in large metropolitan counties. Discontinuation rates were also higher in the Midwest or South compared to the Northeast or West. Veterans with documented clinical indicators of limited life expectancy (e.g., pressure ulcers, malnutrition) or those receiving specialty palliative care, were more likely to have LBMs discontinued.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among community\u2010dwelling older veterans in their final year of life, 73% were receiving at least one LBM at the start of that year, and 78% of these individuals continued LBM use until death. These rates parallel those reported in long\u2010term care populations and underscore the need for community\u2010based healthcare providers to routinely screen for LBMs and support appropriate medication discontinuation in older patients with advanced illnesses and limited life expectancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70381","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T11:51:12Z","timestamp":1775130672000},"page":"1326-1338","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Discontinuation of Medications With Limited Benefit at End of Life in Community\u2010Dwelling Older Veterans"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0775-6663","authenticated-orcid":false,"given":"Joshua M.","family":"Thorpe","sequence":"first","affiliation":[{"name":"Center for Healthcare Evaluation Research and Promotion; Veterans Affairs (VA). Pittsburgh Healthcare System  Pittsburgh Pennsylvania USA"},{"name":"U.N.C. Eshelman School of Pharmacy, University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0269-5339","authenticated-orcid":false,"given":"Kelvin A.","family":"Tran","sequence":"additional","affiliation":[{"name":"Center for Healthcare Evaluation Research and Promotion; Veterans Affairs (VA). Pittsburgh Healthcare System  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherrie L.","family":"Aspinall","sequence":"additional","affiliation":[{"name":"Center for Healthcare Evaluation Research and Promotion; Veterans Affairs (VA). Pittsburgh Healthcare System  Pittsburgh Pennsylvania USA"},{"name":"Center for Medication Safety, Veterans Affairs  Hines Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8059-9281","authenticated-orcid":false,"given":"Shelli L.","family":"Feder","sequence":"additional","affiliation":[{"name":"Yale University School of Nursing  Orange Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brystana G.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center  Durham North Carolina USA"},{"name":"Population Health Sciences, Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Kutney\u2010Lee","sequence":"additional","affiliation":[{"name":"Center for Healthcare Evaluation Research and Promotion; Corporal Michael J. 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