Thomas S Inui
Biographic Data
| ID | 188757 |
|---|---|
| NAME | Thomas S Inui |
| GIVEN NAMES | Thomas S |
| FAMILY NAME | Inui |
| SIGNATURE | INUI T S |
| AFFILIATIONS | University of Washington |
| VERIFIED | No |
| TOTAL WORKS | 40 |
| TOTAL CITATIONS | 72 |
| AUTHOR COUNT | 40 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1979 |
| LATEST PUBLICATION YEAR | 2017 |
| H-INDEX | 4 |
Fukushima after the Great East Japan Earthquake
BACKGROUND: On 11 March 2011, the Great East Japan Earthquake, followed by a tsunami and nuclear-reactor meltdowns, produced one of the most severe disasters in the history of Japan. The adverse impact of this 'triple disaster' on the health of local populations and the health system was substantial. In this study we examine population-level health indicator changes that accompanied the disaster, and discuss options for re-designing Fukushima's h…
Impact of Community Health Workers on Elderly Patients’ Advance Care Planning and Health Care Utilization
BACKGROUND: Advance care planning (ACP) is recommended for all persons to ensure that the care they receive aligns with their values and preferences. OBJECTIVE: To evaluate an ACP intervention developed to better meet the needs and priorities of persons with chronic diseases, including mild cognitive impairment. RESEARCH DESIGN: A year-long, pre-post intervention using lay community health workers [care coordinator assistants (CCAs)] trained to c…
Barriers and Facilitators to Nurse Management of Hypertension
Nurse management of hypertension is a potentially feasible strategy to address the human resource challenge of hypertension control in low-resource settings. However, successful implementation will be contingent upon addressing barriers such as access to medications, quality of care, training of nurses, health education, and stigma
Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya
Knowledge of one's own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of …
Comprehensive Evaluation of Caregiver-Reported Antiretroviral Therapy Adherence for HIV-Infected Children
The Associations of Clinicians’ Implicit Attitudes About Race With Medical Visit Communication and Patient Ratings of Interpersonal Care
Objectives. We examined the associations of clinicians’ implicit attitudes about race with visit communication and patient ratings of care. Methods. In a cross-sectional study of 40 primary care clinicians and 269 patients in urban community-based practices, we measured clinicians’ implicit general race bias and race and compliance stereotyping with 2 implicit association tests and related them to audiotape measures of visit communication and pat…
Rooting Inquiry in Tradition
The baraza is a customary form of community assembly in East Africa. We examined the use of the health baraza as a process that can improve data collection and deepen community understanding of sociocultural issues surrounding HIV/AIDS. In the evaluation of the United States Agency for International Development (USAID)-Academic Model for Prevention and Treatment of HIV/AIDS Partnership (USAID-AMPATH) in Kenya, investigators facilitated mabaraza (…
The Indiana Chronic Disease Management Program′s Impact on Medicaid Claims
BACKGROUND: : Disease management programs have grown in popularity over the past decade as a strategy to curb escalating healthcare costs for persons with chronic diseases. OBJECTIVES: : To evaluate the effect of the Indiana Chronic Disease Management Program (ICDMP) on the longitudinal changes in Medicaid claims statewide. RESEARCH DESIGN: : Phased implementation of a chronic disease management program in 3 regions of the state. Fourteen repeate…
Factors Sustaining Pediatric Adherence to Antiretroviral Therapy in Western Kenya
Antiretroviral therapy (ART) requires nearly perfect adherence to be effective. Although 90% of HIV-infected children live in Africa, there are limited data on pediatric adherence from this multicultural continent.We conducted a qualitative study to identify key factors contributing to pediatric ART adherence. Ten focus group discussions (N = 85) and 35 individual interviews were conducted with parents and guardians of HIV-infected children recei…
Triangulating' Ampath
Clinical programmes are typically evaluated on operational performance metrics of cost, quality and outcomes. Measures of patient satisfaction are used to assess the experience of receiving care, but other perspectives, including those of staff and communities, are not often sought or used to assess and improve programmes. For strategic planning, the Kenyan HIV/AIDS programme AMPATH (Academic Model Providing Access to Healthcare) sought to evalua…
Are Performance Measures Based on Automated Medical Records Valid for Physician/Practice Profiling of Asthma Care
BACKGROUND: The use of physician profiles in "pay for performance" initiatives depend on their reliability and accuracy. OBJECTIVES: To evaluate whether health care delivery units (practices) can be reliably differentiated using the Health Employers Data Information System (HEDIS) performance measure. RESEARCH DESIGN: Simulation was used to describe the relationship between practice size (number of children with persistent asthma) and precision o…
Relationship-centered Care. A Constructive Reframing
Indiana Chronic Disease Management Program Risk Stratification Analysis
OBJECTIVE: The objective of this study was to compare the ability of risk stratification models derived from administrative data to classify groups of patients for enrollment in a tailored chronic disease management program. SUBJECTS: This study included 19,548 Medicaid patients with chronic heart failure or diabetes in the Indiana Medicaid data warehouse during 2001 and 2002. MEASURES: To predict costs (total claims paid) in FY 2002, we consider…
Measuring Patientsʼ Perceptions of the Outcomes of Treatment for Early Prostate Cancer
BACKGROUND: Compared with careful attention to the physical (eg, urinary, bowel, sexual) dysfunction that may follow treatment, little attention has been given to the behavioral, emotional, and interpersonal changes that the diagnosis of early prostate cancer and subsequent physical dysfunction may bring. OBJECTIVE: To construct patient-centered measures of the outcomes of treatment for early prostate cancer. RESEARCH DESIGN: Qualitative study fo…
A council of elders
Validation of Patient Reports, Automated Pharmacy Records, and Pill Counts With Electronic Monitoring of Adherence to Antihypertensive Therapy
OBJECTIVES: To evaluate the validity of patient report, pharmacy dispensing records, and pill counts as measures of antihypertensive adherence using electronic monitoring as the validation standard. METHODS: The study was conducted among 286 members of Harvard Pilgrim Health Care, a managed care organization, who were at least 18 years of age, on monotherapy for hypertension, and had prescription drug coverage. Prescription refill adherence durin…
The seattle appropriate level of care survey
We surveyed 77 persons with AIDS, their physicians and their social workers during the autumn of 1987 to ascertain health status and to quantify use of health services in Seattle, Washington. Participants included the majority (59%) of persons living with AIDS in the area. Information was gathered regarding demography, health status, functional status, medical history and the use of health services. The validity of self-assessed general health wa…
Physician Frustration in Communicating with Patients
In this study, the nature of practicing physicians' "frustrating" visits was explored and a guide to help physicians identify problems in communicating with patients was developed. The study included 1,076 practicing physicians who attended a voluntary workshop on physician-patient communication. The physicians were from multiple specialties and diverse work settings geographically dispersed throughout the United States. The method included devel…
Meta-analysis of Home-Care Effects on Mortality and Nursing-Home Placement
This meta-analysis was designed to illustrate how the relatively new discipline of meta-analysis could be employed in health-services research. In pursuit of this goal, the results of 13 studies on the effect of home care on mortality and nursing-home placements were examined. The analysis demonstrated a small, beneficial effect of home care on mortality, which fell short of statistical significance. Study-to-study variation in the odds ratio was…
The Sickness Impact Profile as a Measure of the Health Status of Noncognitively Impaired Nursing Home Residents
The Sickness Impact Profile (SIP) is a multidimensional, behaviorally based measure of the health status that has been successfully used in a wide range of applications. The characteristics of this measure have not been assessed with nursing home residents. The purpose of this study was to assess the feasibility, reliability (internal consistency), validity, and comprehensiveness of the SIP as a measure of the health status of a selected group of…
Introduction of information during the initial medical visit
A General Method of Compliance Assessment Using Centralized Pharmacy Records
The prescription refill records of centralized pharmacies are a potential source of information about patient compliance with long-term medications. We developed a method for assessing compliance in such settings and validated our measures using pharmacy data and clinical information from patients with seizure disorders and hypertension. For patients taking the anticonvulsant medication phenytoin, compliance with the drug correlated significantly…
The interaction of mental illness, criminal behavior and culture
The Relationship of Attitude Changes to Compliance With Influenza Immunization
In a longitudinal, prospective study of patient's decisions about influenza vaccination, the stability of attitudes about the flu and flu shots, the stability of flu shot decisions, and the relationship of attitude shifts to compliance were studied. In both 1981 and 1982 for 216 patients at high risk for complications of influenza, attitudes about 15 issues in the decision to obtain a flu shot were measured and each patient's behavioral intention…
Problems and Prospects for Health Services Research on Provider-Patient Communication
The effectiveness of medical practice is largely dependent on the quality of provider-patient communication. Inputs to the provider-patient encounter include prior experience with medical care, patient objectives for the visit, patient age, type of medical problem, the number of patient concerns, and characteristics of the physician's practice setting. Outcomes linked to the communication process include patient knowledge, provider-patient congru…
The Associations of Clinicians’ Implicit Attitudes About Race With Medical Visit Communication and Patient Ratings of Interpersonal Care
Objectives. We examined the associations of clinicians’ implicit attitudes about race with visit communication and patient ratings of care. Methods. In a cross-sectional study of 40 primary care clinicians and 269 patients in urban community-based practices, we measured clinicians’ implicit general race bias and race and compliance stereotyping with 2 implicit association tests and related them to audiotape measures of visit communication and pat…
A council of elders
Introduction of information during the initial medical visit
Rooting Inquiry in Tradition
The baraza is a customary form of community assembly in East Africa. We examined the use of the health baraza as a process that can improve data collection and deepen community understanding of sociocultural issues surrounding HIV/AIDS. In the evaluation of the United States Agency for International Development (USAID)-Academic Model for Prevention and Treatment of HIV/AIDS Partnership (USAID-AMPATH) in Kenya, investigators facilitated mabaraza (…
Factors Sustaining Pediatric Adherence to Antiretroviral Therapy in Western Kenya
Antiretroviral therapy (ART) requires nearly perfect adherence to be effective. Although 90% of HIV-infected children live in Africa, there are limited data on pediatric adherence from this multicultural continent.We conducted a qualitative study to identify key factors contributing to pediatric ART adherence. Ten focus group discussions (N = 85) and 35 individual interviews were conducted with parents and guardians of HIV-infected children recei…
Fulfillment of patient requests in a general medicine clinic
For initial visits to a longitudinal-care internal medicine clinic, we elicited patients' requests for problems to be addressed, measured patients' assessments of request fulfillment, and determined correlates of request fulfillment. Patients rated all requests as fulfilled in 62 of 71 cases (87 per cent). Fewer pre-encounter patient-reported problems, discretionary features of the doctor-patient encounter including more time spent eliciting hist…
Effects of a Self-Administered Health History on New-Patient Visits in a General Medical Clinic
Self-administered health history questionnaires (SAHHQs) are widely used in ambulatory care settings to save provider time and to assure completeness of the clinical data base. A controlled, prospective study was undertaken in a general medical clinic to evaluate the impact of an extensively pretested, highly reliable, 120-item self-administered health history questionnaire developed for new patient visits. Seventy-seven patients were randomly as…
Hospital Screening for Tuberculosis A Quality Assurance Trial
A quality assurance trial which dealth with tuberculin testing and isoniazid prophylaxis for tuberculosis infection among hospitalized patients was undertaken at a short-term, general hospital of the Indian Health Service. Standards for care were developed by the hospital staff using questionnaire and Delphi process techniques. Following the demonstration of baseline deficiencies in clinical performance, tuberculin testing became a standing admis…
Variations in Patient Compliance with Common Long-Term Drugs
An indirect measure of adherence to drug regimens was developed from pharmacy records of prescription refills. This measure was validated by demonstrations of significant relationships between compliance with hydrochlorothiazide and propranolol and expected physiologic effects of these drugs (decreased blood pressures and decreased pulse rates, respectively). The measure was used to survey compliance with 20 common drugs prescribed to 419 outpati…
Dropouts and Broken Appointments
Patient dropouts create inefficiencies for medical providers, threaten the validity of clinical research and may themselves suffer unnecessary morbidity. A review of literature concerning patient dropouts and broken appointments was undertaken in an effort to identify correlates of the behavior, assess proposed interventions and identify issues for the content and methodology of future research. While the bulk of existing reports deal with psychi…
Identifying Hospital Patients Who Need Early Discharge Planning for Special Dispositions
Identifying patients early in their hospitalizations who need discharge planning to arrange special care dispositions is a difficult task. Failure to achieve early identification may result in unnecessarily prolonged hospital stays and a less orderly process of planning. In this study three brief rating instruments for identifying such patients were compared and found to have different performance characteristics when applied to a large populatio…
Screening for Noncompliance Among Patients With Hypertension
The substantial prevalence of noncompliance with drugs in populations of patients with treated hypertension suggests that a reliable, clinically applicable screening test for this behavior is needed. Among employed white males, patient response to a nonjudgmental clinician inquiry has been reported to be highly predictive of noncompliance when positive but relatively insensitive (40 per cent). We assessed the performance of patient self-report in…
Critical Reading Seminars for Medical Residents
The purpose and structure of a "critical reading seminar" series for second-year residents in medicine is described. This seminar has been a useful and popular forum for teaching research methodology and critical reading skills to physicians-in-training. Seminar content has emphasized the strength and limitations of research design, sampling and subject allocation, measures and techniques of analysis. Explanations for the popularity of these teac…
Learning to Live With Angina
Inui, Thomas S. Sc.M., M.D.; Lipsky, Benjamin A. M.D.; Kupersmith, Walter J. B.A. Author Information
Outcome-Based Doctor-Patient Interaction Analysis
Interactional analysis (IA) systems have been devised and applied to doctor-patient dialogues to describe encounters and to relate process to outcomes. Prior work in this area has been typified by the use of a single taxonomy for classifying verbal behaviors and limited outcomes (compliance and/or satisfaction). We applied three different IA systems (Bales, Roter's modified Bales with affective ratings, and Stiles' "Verbal Response Modes") to 101…
Outcome-Based Doctor-Patient Interaction Analysis
Three interactional analysis (IA) systems (Bales', Roters modified Bales and Stiles' "Verbal response modes") were used to characterize behavioral elements of provider-patient dialogues of 101 new-patient visits in a general medical clinic. In a previous article, the explanatory power of these IA systems was compared. In this article, specific provider and patient behaviors within segments of the encounter (introduction-history, physical examinat…
Response to Wong and Watkins
Systematic Analysis of Clinician-Patient Interactions
Clinician-patient interactions are an important, but poorly understood, feature of our personal health care system. Attributes of these interactions have been shown to affect the health care process and appear as well to be amenable to change, furnishing a rationale for their study. Communications theory provides useful guidelines for systematic analysis. Systems of interaction analysis should take account of information transfer occurring on dif…
Measuring Functional Outcomes in Chronic Disease
A new "health-status" questionnaire, the Sickness Impact Profile (SIP), was examined to determine whether it offered measurement advantages over the traditional American Rheumatism Association (ARA) functional scale or patient self-ratings of function. Seventy-nine outpatients with rheumatoid arthritis (RA) administered the SIP to themselves and provided self-ratings on a 7-point functional scale. Clinicians independently rated patients on the AR…
Fulfillment of patient requests in a general medicine clinic
For initial visits to a longitudinal-care internal medicine clinic, we elicited patients' requests for problems to be addressed, measured patients' assessments of request fulfillment, and determined correlates of request fulfillment. Patients rated all requests as fulfilled in 62 of 71 cases (87 per cent). Fewer pre-encounter patient-reported problems, discretionary features of the doctor-patient encounter including more time spent eliciting hist…
Patient Requests and Expectations
From the Division of Gerontology and Geriatric Medicine, Department of Medicine, Harborview Medical Center, University of Washington, Seattle, Washington †From Northwest Health Services Research and Development Field Program, Medical Comprehensive Care Unit, Seattle Veterans Administration Medical Center, and the Robert Wood Johnson Clinical Scholars Program, University of Washington, Seattle, Washington ‡From Northwest Health Services Research a…
The Relationship of Attitude Changes to Compliance With Influenza Immunization
In a longitudinal, prospective study of patient's decisions about influenza vaccination, the stability of attitudes about the flu and flu shots, the stability of flu shot decisions, and the relationship of attitude shifts to compliance were studied. In both 1981 and 1982 for 216 patients at high risk for complications of influenza, attitudes about 15 issues in the decision to obtain a flu shot were measured and each patient's behavioral intention…
Problems and Prospects for Health Services Research on Provider-Patient Communication
The effectiveness of medical practice is largely dependent on the quality of provider-patient communication. Inputs to the provider-patient encounter include prior experience with medical care, patient objectives for the visit, patient age, type of medical problem, the number of patient concerns, and characteristics of the physician's practice setting. Outcomes linked to the communication process include patient knowledge, provider-patient congru…
The interaction of mental illness, criminal behavior and culture
A General Method of Compliance Assessment Using Centralized Pharmacy Records
The prescription refill records of centralized pharmacies are a potential source of information about patient compliance with long-term medications. We developed a method for assessing compliance in such settings and validated our measures using pharmacy data and clinical information from patients with seizure disorders and hypertension. For patients taking the anticonvulsant medication phenytoin, compliance with the drug correlated significantly…
Meta-analysis of Home-Care Effects on Mortality and Nursing-Home Placement
This meta-analysis was designed to illustrate how the relatively new discipline of meta-analysis could be employed in health-services research. In pursuit of this goal, the results of 13 studies on the effect of home care on mortality and nursing-home placements were examined. The analysis demonstrated a small, beneficial effect of home care on mortality, which fell short of statistical significance. Study-to-study variation in the odds ratio was…
The Sickness Impact Profile as a Measure of the Health Status of Noncognitively Impaired Nursing Home Residents
The Sickness Impact Profile (SIP) is a multidimensional, behaviorally based measure of the health status that has been successfully used in a wide range of applications. The characteristics of this measure have not been assessed with nursing home residents. The purpose of this study was to assess the feasibility, reliability (internal consistency), validity, and comprehensiveness of the SIP as a measure of the health status of a selected group of…
Introduction of information during the initial medical visit
The seattle appropriate level of care survey
We surveyed 77 persons with AIDS, their physicians and their social workers during the autumn of 1987 to ascertain health status and to quantify use of health services in Seattle, Washington. Participants included the majority (59%) of persons living with AIDS in the area. Information was gathered regarding demography, health status, functional status, medical history and the use of health services. The validity of self-assessed general health wa…
Physician Frustration in Communicating with Patients
In this study, the nature of practicing physicians' "frustrating" visits was explored and a guide to help physicians identify problems in communicating with patients was developed. The study included 1,076 practicing physicians who attended a voluntary workshop on physician-patient communication. The physicians were from multiple specialties and diverse work settings geographically dispersed throughout the United States. The method included devel…
Validation of Patient Reports, Automated Pharmacy Records, and Pill Counts With Electronic Monitoring of Adherence to Antihypertensive Therapy
OBJECTIVES: To evaluate the validity of patient report, pharmacy dispensing records, and pill counts as measures of antihypertensive adherence using electronic monitoring as the validation standard. METHODS: The study was conducted among 286 members of Harvard Pilgrim Health Care, a managed care organization, who were at least 18 years of age, on monotherapy for hypertension, and had prescription drug coverage. Prescription refill adherence durin…
Medicine (36 works) · Psychology (22 works) · Family medicine (18 works) · Nursing (15 works) · Health care (11 works) · Political science (10 works) · Internal Medicine (9 works) · Internal Medicine (8 works) · MEDLINE (8 works) · Social Psychology (8 works)