Sunil Kripalani

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CONTEXT Predicting hospital readmission risk is of great interest to identify which patients would benefit most from care transition interventions, as well as to risk-adjust readmission rates for the purposes of hospital comparison. OBJECTIVE To summarize validated readmission risk prediction models, describe their performance, and assess suitability for(More)
CONTEXT Delayed or inaccurate communication between hospital-based and primary care physicians at hospital discharge may negatively affect continuity of care and contribute to adverse events. OBJECTIVES To characterize the prevalence of deficits in communication and information transfer at hospital discharge and to identify interventions to improve this(More)
BACKGROUND Approximately 20% to 50% of patients are not adherent to medical therapy. This review was performed to summarize, categorize, and estimate the effect size (ES) of interventions to improve medication adherence in chronic medical conditions. METHODS Randomized controlled trials published from January 1967 to September 2004 were eligible if they(More)
The period following discharge from the hospital is a vulnerable time for patients. About half of adults experience a medical error after hospital discharge, and 19%-23% suffer an adverse event, most commonly an adverse drug event. This article reviews several important challenges to providing high-quality care as patients leave the hospital. These include(More)
OBJECTIVE Patients with low health literacy have difficulty understanding prescription drug labels and other medication instructions. This article describes the development, implementation, and preliminary evaluation of an illustrated medication schedule (a "pill card") that depicts a patient's daily medication regimen using pill images and icons. METHODS(More)
Medication nonadherence remains a significant obstacle to achieving improved health outcomes in patients with chronic disease. Self-efficacy, the confidence in one's ability to perform a given task such as taking one's medications, is an important determinant of medication adherence, indicating the need for reliable and valid tools for measuring this(More)
BACKGROUND People who are prescribed self-administered medications typically take less than half the prescribed doses. Efforts to assist patients with adherence to medications might improve the benefits of prescribed medications, but also might increase their adverse effects. OBJECTIVES To update a review summarizing the results of randomized controlled(More)
BACKGROUND The factors influencing medication adherence have not been fully elucidated. Inadequate health literacy skills may impair comprehension of medical care instructions, and thereby reduce medication adherence. OBJECTIVES To examine the relationship between health literacy and medication refill adherence among Medicare managed care enrollees with(More)
BACKGROUND Over the past decade, handheld computers (or personal digital assistants [PDAs]) have become a popular tool among medical trainees and physicians. Few comprehensive reviews of PDA use in medicine have been published. OBJECTIVE We systematically reviewed the literature to (1) describe medical trainees' use of PDAs for education or patient care,(More)
BACKGROUND Professional organizations recommend that physicians discuss prostate cancer with patients to make individual screening decisions. However, few studies have tested strategies to encourage such discussions, particularly among high-risk populations. We examined the effects of two low-literacy interventions on the frequency of prostate cancer(More)