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More Than Half of Asian Americans With Diabetes Are Undiagnosed

More than half of Asian Americans and nearly half of Hispanic Americans with diabetes are undiagnosed, according to researchers from the National Institutes of Health and the Centers for Disease Control and Prevention (CDC). Their results were published in the Journal of the American Medical Association. Additionally, prevalence of diabetes for all American adults went up, from nearly 10% to over 12% between 1988 and 2012. Diabetes prevalence-how common the condition is-also went up in every age, sex, level of education, income, and racial/ethnic subgroup. One bright spot: The proportion of people with diabetes that was undiagnosed decreased 23% between 1988-1994 and 2011-2012. The statistics account for age differences across the surveys. Using newly available 2011-2012 data from the CDC's National Health and Nutrition Examination Survey, researchers were able to quantify diabetes prevalence for Asian Americans for the first time and found that they have the highest proportion of diabetes that was undiagnosed among all ethnic and racial subgroups studied, at 51%. Diabetes was also common in Asian Americans, at 21%. Hispanic Americans had the highest prevalence of diabetes at nearly 23%, with 49% of that undiagnosed.

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Today's Heroin Epidemic

Heroin use has increased across the United States among men and women, most age groups, and all income levels. Some of the greatest increases occurred in demographic groups with historically low rates of heroin use: women, the privately insured, and people with higher incomes. Not only are people using heroin, they are also abusing multiple other substances, especially cocaine and prescription opioid painkillers. As heroin use has increased, so have heroin-related overdose deaths. Between 2002 and 2013, the rate of heroin-related overdose deaths nearly quadrupled, and more than 8,200 people died in 2013. States play a central role in prevention, treatment, and recovery efforts for this growing epidemic.

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* Heroin use more than doubled among young adults ages 18 to 25 in the past decade.


* More than 9 in 10 people who used heroin also used at least one other drug.


* Forty-five percent of people who used heroin were also addicted to prescription opioid painkillers.



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AHRQ Stats: Hospital Discharge Instructions

The percentage of hospitalized adult patients with heart failure who were given complete written discharge instructions improved from 57% in 2005 to almost 94% in 2012. (Source: Agency for Healthcare Research and Quality, 2014 National Healthcare Quality and Disparities Report Chartbook on Care Coordination.)

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AHRQ Study: Electronic Prescribing Linked to Fewer Adverse Drug Events Among Patients With Diabetes

Physicians who primarily issue prescriptions electronically have lower rates of adverse drug events (ADEs) among their patients with diabetes, according to an AHRQ study in the Journal of the American Medical Informatics Association. The study used 2011 Medicare Part D drug claims data, representing nearly 28 million Medicare beneficiaries, to investigate ADE rates of physicians who used e-prescribing for 50% or more of prescriptions (and therefore met the Centers for Medicare and Medicaid Services meaningful use stage 2 threshold for e-prescribing). Those physicians were compared with physicians who prescribed primarily in writing, by telephone or in other ways. Of nearly 130,000 physicians included in the study, 25% were considered high e-prescribers because they met the meaningful use threshold in 2011. Five percent of high e-prescribers had at least one patient with an ADE, compared with 6.5% of low e-prescribers. High e-prescribing was associated with a reduced risk of hospital or emergency department visits for hypoglycemia or ADEs related to antidiabetes medications. The study, "Meaningful Use Stage 2 E-Prescribing Threshold and Adverse Drug Events in the Medicare Part D Population With Diabetes," and abstract were published May 6. Coauthors included AHRQ's William Encinosa, PhD.

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Electronic Medical Records

Significant policy changes and public investments have advanced the adoption of health information technology. However, more needs to be done to move the nation toward a truly interoperable healthcare system. In 2015, 9 years after the first Health Information Technology in the United Sates report was released, a large percentage of acute care hospitals have at least a basic electronic health record (EHR) system. But many are not ready to meet Stage 2 meaningful use criteria-criteria that must be met in order to participate in the Medicare and Medicaid HER Incentive programs.


Key Findings


* By 2014, 75.5% of hospitals had adopted at least a basic EHR, a substantial increase from 58.9% in 2013.


* Seventy-six percent of hospitals reported exchanging data with outside healthcare professionals in 2014, up from 62% in 2013 and 41% in 2008, the year the survey began including this measure.


* Hospitals continue to face barriers toward adopting national standards enacted in 2009 to encourage technology investments and the development of health information exchanges.



The HITECH Act of 2009 encouraged technology investments and the development of local and regional health information exchanges for sharing of clinical data such as care records, discharge summaries, and test results. However, hospitals continue to face barriers toward adopting these standards-especially those pertaining to financial viability and sustainability.


Just-Launched Nursing Certification in Care Coordination Means Smoother Passage Through the Healthcare System

PITMAN, NJ-Navigating through today's healthcare system can be a maze of confusion for even the savviest of patients. Thanks to a new nursing certificate in care coordination and transition management (CCTM), patients will have a vastly improved chance of getting the right care at the right time by the right provider. The exam was launched by the Medical-Surgical Nursing Certification Board (MSNCB) on September 1, 2015. MSNCB collaborated with the American Academy of Ambulatory Care Nursing (AAACN), which contributed additional leadership, expertise, and study resources. Nurses who pass the exam will earn the credential "Certified in Care Coordination and Transition Management" (CCCTM). "Nurses have been coordinating care and managing transitions for decades, however the need for - and complexity of - care coordination has increased dramatically," MSNCB President Mimi Haskins, DNP, RN, CNS, CMSRN, said. The CCCTM credential will validate the knowledge and expertise of RNs in this role. Patients and facilities will reap the benefits of better-coordinated and more cost-effective care, including preventive and health promotion strategies. The exam is administered by MSNCB and is based on AAACN's Care Coordination and Transition Management Core Curriculum. RNs who have a minimum of 2 years' experience in a CCTM role and at least 2,000 hours of CCTM practice within the last 3 years are eligible. According to Haskins, the pressure on healthcare facilities to achieve better outcomes is greater now than ever before. "This means registered nurses who have earned the CCCTM credential will be in great demand and will have a competitive edge in the job market," she said.


Complete information about the CCCTM exam is available at


Landmark NIH Study Shows Intensive Blood Pressure Management May Save Lives

More intensive management of high blood pressure, below a commonly recommended blood pressure target, significantly reduces rates of cardiovascular disease, and lowers risk of death in a group of adults 50 years and older with high blood pressure. This is according to the initial results of a landmark clinical trial sponsored by the National Institutes of Health called the Systolic Blood Pressure Intervention Trial (SPRINT). The intervention in this trial, which carefully adjusts the amount or type of blood pressure medication to achieve a target systolic pressure of 120 mL of mercury (mm Hg), reduced rates of cardiovascular events, such as heart attack and heart failure, as well as stroke, by almost a third and the risk of death by almost a quarter, as compared to the target systolic pressure of 140 mm Hg. "This study provides potentially lifesaving information that will be useful to health care providers as they consider the best treatment options for some of their patients, particularly those over the age of 50," said Gary H. Gibbons, MD, director of the National Heart, Lung, and Blood Institute (NHLBI), the primary sponsor of SPRINT. "We are delighted to have achieved this important milestone in the study in advance of the expected closure date for the SPRINT trial and look forward to quickly communicating the results to help inform patient care and the future development of evidence-based clinical guidelines."

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