Publications by authors named "L J Wastila"

Background: Two long-acting muscarinic antagonist inhaler fixed dose combinations (olodaterol/tiotropium (OLO/TIO) and vilanterol/umeclidinium (VI/UMEC)) have once-a-day dosing for managing chronic obstructive pulmonary disease (COPD). This study aimed to compare clinical effectiveness of these inhalers in terms of ability to prevent severe COPD exacerbations in a United States Medicare population.

Research Design And Methods: Using nationally representative Medicare data (2013-2019), we employed a new user, active comparator design among beneficiaries aged 65 years and older with COPD.

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Objectives: Survey nursing home (NH) clinicians about the indications for NH gabapentinoid use, the factors driving increased prescribing, and their experiences with gabapentinoid deprescribing.

Design: Online clinician survey.

Setting And Participants: NH clinicians prescribing gabapentinoids in US NHs.

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Background: Pilot data suggest that off-label, unmonitored antiepileptic drug prescribing for behavioral and psychological symptoms of dementia is increasing, replacing other psychotropic medications targeted by purposeful reduction efforts. This trend accelerated during the COVID-19 pandemic. Although adverse outcomes related to this trend remain unknown, preliminary results hint that harms may be increasing and concentrated in vulnerable populations.

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Objectives: Explore the indications for long-stay gabapentin use and elucidate the factors spurring the rapid increase in gabapentin prescribing in nursing homes (NHs).

Methods: National cross-sectional survey of NH prescribers distributed anonymously using SurveyMonkey. Sampling for convenience was obtained through crowdsourcing, leveraging collaborations with NH clinician organizations.

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The Centers for Medicare & Medicaid Services (CMS) grades nursing home performance in antipsychotic prescribing quarterly, publishing findings as a quality measure. While scores have improved since 2011, marked performance variation between facilities persists. To assess quality gap changes between best- and worst-performing deciles, we compared quarterly prescribing changes between these groups pre-pandemic (April 2011 to March 2020) and during the pandemic (April 2020 to March 2022).

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