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THIS ISSUE AVAILABLE ONLINE WITH EXPANDED INFORMATION AND PHOTOS AT:
www.hhs.gov/news/newsletter/weekly

IN THIS ISSUE:
1) Secretary Thompson launches "Small Steps, Big Rewards"
2) HHS moves to focus regulations on improved patient care
3) FDA approves heart assist pump for permanent use
4) Medicare announces seven-state pilot program to help seniors stop smoking
5) Surgeon General sets prevention as top priority
6) Driving under the influence of drugs increases in U.S.

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Secretary Thompson launches "Small Steps, Big Rewards"

HHS Secretary Thompson has launched "Small Steps, Big Rewards," a new national diabetes prevention campaign in an effort to stem the explosion of diabetes by emphasizing to millions of Americans that modest lifestyle changes can do much to prevent the onset of type 2 diabetes, the most common form of the disease.

"This campaign says that there is hope for the millions of American who are at risk for developing diabetes," Secretary Thompson said. "You don't have to be a marathon runner or starve yourself to prevent diabetes. You can make small changes and take small steps that translate into big rewards."

"Small Steps, Big Rewards" is just one of the many initiatives and programs undertaken as part of the Secretary's Prevention Campaign. The Prevention Campaign aims to get Americans to stop smoking, improve their diets, and engage in physical activity. With an estimated 35 Americans dying every hour from causes related to inactivity and poor nutrition, and with the effects of smoking, diabetes, and obesity costing the economy almost $270 billion annually, the Prevention Campaign is a common sense effort to improve America's health.

Nationally, diabetes has increased nearly 50 percent in the past 10 years, and the incidence is expected to grow another 165 percent by 2050 under current trends. About 17 million Americans have diabetes, which includes 16 million people with type 2 diabetes. In addition, at least 16 million more Americans have pre-diabetes, a condition that raises a person's risk of getting type 2 diabetes.

The "Small Steps, Big Rewards" campaign grew out of findings from the department's landmark Diabetes Prevention Program clinical trial, which showed that people with pre-diabetes can delay and possibly prevent type 2 diabetes by losing just 5 to 7 percent of their body weight through moderate changes in diet and physical activity.

Risk factors for diabetes and pre-diabetes include being overweight, a sedentary lifestyle, being age 45 or older, having high blood pressure, low HDL cholesterol and high triglycerides, a family history of diabetes, a history of gestational diabetes or giving birth to a baby weighing more than 9 pounds, and belonging to a racial or ethnic minority group.

The new campaign will be administered by the National Diabetes Education Program, which is jointly sponsored by HHS' National Institutes of Health and the Centers for Disease Control and Prevention. More information on the new campaign and on the diagnosis and treatment of diabetes and pre-diabetes is available at www.ndep.nih.gov or by calling 1-800-438-5383.

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HHS moves to focus regulations on improved patient care

HHS' Advisory Committee on Regulatory Reform on Thursday issued its final report highlighting hundreds of specific recommendations for improving regulatory requirements across HHS agencies, including many that HHS has already moved to implement or address.

"One by one, we are removing the unnecessary barriers between patients and their doctors, nurses and other health care providers," Secretary Tommy G. Thompson said. "By restoring common sense to our regulatory system, we are helping health care professionals spend more time caring for patients and less time consumed with paperwork."

Secretary Thompson last year created the advisory panel of consumers, doctors, nurses and other professionals to help guide HHS' broader efforts to streamline unnecessarily burdensome or inefficient regulations that interfere with the delivery of and access to quality health care for Americans.

The panel's final report urges a broad range of actions in order to reduce the potential harm to patients that may result from unnecessarily complex, confusing and burdensome regulations. The panel made a total of 255 recommendations to reduce potential obstacles to patients' access to care, reduce the time doctors and other health care professionals must spend on paperwork, improve communication with consumers, and improve the use of technology to promote quality care while ensuring patients have strong privacy protections. HHS has already implemented 26 of those recommendations.

"Our goal has been to highlight ways to improve the quality of care that patients receive by focusing on some of the unintended consequences of various regulations," said Chairman Douglas L. Wood, M.D., a practicing cardiologist at the Mayo Clinic. "Already, Secretary Thompson has moved to implement many of our ideas in ways that better serve patients. This shows the department's real willingness to consider smarter ways to regulate health care."

The committee's final report will be available at www.regreform.hhs.gov.

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FDA approves heart assist pump for permanent use

The Food and Drug Administration has approved a heart assist pump to be implanted permanently in certain terminally ill patients who are not eligible for a heart transplant.

The device, called HeartMate, is a left ventricular assist device made by Thoratec Corporation, of Pleasonton, Calif. It assists weakly beating hearts by taking over the work of the heart's main pumping chamber, the left ventricle.

The HeartMate was previously approved solely as a bridge for patients eligible for heart transplants and waiting for an available heart. This approval expands the availability of HeartMate to certain people with severe end-stage congestive heart failure.

"Heart technology is developing rapidly and holds great promise for the future," said Deputy FDA Commissioner Lester M. Crawford. "Devices like the one approved today can add months to the lives of terminally ill heart patients. In the future, these devices may be able to extend life even longer and ultimately may have a major impact on the treatment of heart failure."

FDA approved the device for expanded use based on the results of a randomized clinical trial conducted by Thoratec in cooperation with the National Institutes of Health and on the recommendation of the Circulatory System Devices Panel of FDA's Medical Devices Advisory Committee.

The study showed that treatment with HeartMate doubled survival at one year compared to drug treatment. However, the increased survival rate came at a price: Implanting the device requires major surgery for already seriously ill people, and many patients experienced bleeding that required re-operation, infection, or stroke.

Because of the serious side effects associated with the device, and the small population in which it was studied, use of the device will be limited to certain very sick patients who have severe end-stage congestive heart failure and are not eligible for a heart transplant. Currently, an estimated 20,000 to 30,000 people in the United States may fall in this category.

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Medicare announces seven-state pilot program to help seniors stop smoking

The Centers for Medicare & Medicaid Services has announced the launch of a pilot program in seven states to study the best way to help older Medicare beneficiaries quit smoking.

"Smoking is the single most preventable cause of disease and death in the United States and poses a significant risk to older Americans," HHS Secretary Tommy G. Thompson said. "It is never too late to quit smoking, even if you have smoked heavily for 30 years or more. In fact, older adults have proven to be more successful at quitting smoking than younger people."

The Medicare Stop Smoking Program will be conducted in Alabama, Florida, Missouri, Nebraska, Ohio, Oklahoma and Wyoming. The pilot program will test smoking cessation strategies with seniors. The strategies will be tested in various combinations, including counseling in person or over the phone, nicotine patches, a prescription smoking cessation drug, and educational materials. All of these services have been demonstrated to help smokers quit. The study will seek to determine which are the most effective for seniors.

Beneficiaries who enroll in the study will receive free smoking cessation therapy, which may range from physician counseling to drugs to help them quit. As a preventive measure, smoking cessation therapy is normally not covered by Medicare, but is covered for those enrolled in this study.

In these states, senior Medicare beneficiaries who smoke and want to quit will be encouraged to call a toll-free telephone number to find out if they are eligible for the study. Only people 65 and older enrolled in fee-for-service Medicare Part B in the seven states are eligible to participate. The number is 1-866-65BEGIN (1-866-652-3446).

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Surgeon General sets prevention as top priority

U.S. Surgeon General Richard Carmona said disease prevention is his "first and most passionate priority" at a recent keynote address at forum co-sponsored by Research!America and The Public Policy Institute of Southern Illinois University in Carbondale.

Carmona emphasized the preventable nature of most of the diseases affecting the United States, "I am looking at disease states: asthma, diabetes, trauma, and obesity, the most pressing issue in health facing the country today," he said.

More than 300,000 Americans die every year because of obesity-related diseases and it costs the nation hundreds of billions of dollars in health care costs and in lost productivity.

"Obesity is an epidemic. If we don't do anything about it we will have a morbidly obese, dysfunctional population whose care we cannot afford," Carmona added.

"We as a society can no longer tolerate the disease burdens that have given us a crisis in health care costs. Bottom line: we need to prioritize our approach. Hence, the value in research."

As an example of the potential of prevention research, Carmona pointed to cardiovascular mortality and morbidity trends over the past few decades following efforts to promote healthy lifestyles. Cardiovascular Disease rates have "lowered because people started exercising, eating right, and keeping their blood pressure in check. The outcome: a healthier segment of society, very cheap to do," he said.

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Driving under the influence of drugs increases in U.S.

Eight million persons aged 12 or older reported driving under the influence of illegal drugs during the past year - a 3.6 percent increase from 2000, according to the National Household Survey on Drug Abuse.

The report also showed that rates of drugged driving increased from 2000 to 2001 for young adults aged 18-34. Among adults aged 18 or older, those who were unemployed were more likely than full- or part-time workers to report driving under the influence of illegal drugs. Overall, drugged driving increased from 3.1 percent in 2000.

"Drugged driving is under-reported because it is under-recognized," SAMHSA Administrator Charles Curie said. "Young people, as well as parents, need to know that driving under the influence of any illegal drug is just as dangerous as driving under the influence of alcohol."

This report was released on Tuesday, Nov. 19 by the Substance Abuse and Mental Health Services Administration (SAMHSA).

Additional information, data and tables as well as copies of the full report can be found on-line at: www.DrugAbuseStatistics.samhsa.gov or by calling 1-800-729-6686.

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Last updated 22 November 2002
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