About Us

The Department of Population Medicine (DPM) resides within the Harvard Pilgrim Health Care Institute, and is an appointing department of Harvard Medical School.  DPM does the research that helps provide information to people at all levels of our health care system, from government health officials to private citizens faced with day-to-day choices about how to maintain their own health.

Many Parents Don’t Understand Their Children’s Asthma Medications

Led by DPM researchers Ann Wu, MD, MPHLingling Li, PhD, and Alison Galbraith, MD, MPH, the study included 740 providers and parents of children age 4-11 years with one or more diagnoses of asthma and one or more dispensing of asthma controller medications.  Those with severe asthma were excluded.  The parents and providers were surveyed by mail, telephone, web, or in person.   

JAMA Medical News & Perspectives highlights the FDA Sentinel Initiative

A new Journal of the American Medical Association (JAMA) article highlights the Food and Drug Administration’s (FDA) Sentinel Initiative.  The JAMA Medical News & Perspectives piece focuses on the progress to date with Sentinel, which was designed to identify potential safety issues by using electronic data to evaluate the safety of marketed drugs, devices, and biologics.  Sentinel’s coordinating center is located at the HPHC Institute and led by DPM Chair Richard Platt, MD, MS

Dr. Alison Galbraith featured on Minnesota Public Radio’s “The Daily Circuit”

On February 3, 2015, Alison Galbraith, MD, MPH of the Center for Child Health Care Studies was featured on Minnesota Public Radio’s program “The Daily Circuit” to discuss high-deductible health plans (HDHPs), which offer lower premiums and higher deductibles than traditional health plans. Dr. Galbraith discussed the affordability of HDHPs for families of varying income levels, and the difficulties many people face when assessing the affordability of different health care options. Listen to the full program here.

Public Health “Emergency”?

In a NEJM Perspective, DPM Fellow Rebecca Haffajee, JD, MPH and colleagues discuss a recent declaration by the Massachusetts governor that the state’s opioid-addiction epidemic constitutes a public health emergency.  
 
With this declaration, the state public health commissioner was able to use emergency powers to implement several actions including: expanding access to naloxone, an opioid antagonist that can reverse overdoses; developing a plan to accelerate the mandatory use of prescription monitoring by physicians and pharmacists; and prohibiting the prescribing and dispensing of an FDA-approved hydrocodone-only medication (Zohydro, Zogenix).
 
Once a public health emergency is declared, actions -- such as military deployment, restricting freedom of movement, or suspension of civil rights -- can be implemented without normal legislative approval or other checks and balances.  Public health emergency powers are typically deployed if the scenario is exigent, if there is a high potential for catastrophic harm, and if avoidance of harm through ordinary means is not possible, such as with an Ebola outbreak or Anthrax attack.
 
The authors discuss whether or not it was appropriate to invoke emergency powers in the case of the opioid-addiction epidemic, since usual legislative procedures -- such as prescription-monitoring mandates and the drafting of related bills -- were already in process.  Moreover, sidestepping the usual legislative process can result in legal actions under federal law. Zogenix, the manufacturer of Zohydro, brought such a challenge, stating that the governor’s ban on its product was unconstitutional and a federal judge ruled in their favor. Finally, although not clearly a concern with the Massachusetts opioid public health emergency declaration, overuse of this tool can infringe upon private business and individual rights, as well as compromise public trust in the government’s use of public health powers.
 
The authors believe that, although the governor’s declaration recommended prudent measures to ameliorate the opioid-addiction crisis in Massachusetts, it sets a disturbing precedent for the use of emergency powers to address certain public health problems.
 
For more interesting discussion and additional details on this topic, access the full article by clicking here.

The Role of Primary Care in Cancer Survivorship Programs

Since the 2006 Institute of Medicine report focusing on the transition of cancer survivors from oncology to primary care settings, there has been growing interest in evaluating the readiness to care for this patient population by primary care providers (PCPs) and the mechanisms that may be used to facilitate the transition from oncology settings. Study findings have shown that although PCPs are often willing to care for cancer survivors, they may lack confidence and skills.
 
Larissa Nekhlyudov, MD, MPH, Associate Professor, has authored an article in Oncologist discussing the role of general internists in the management of cancer patients. Specifically, the article proposes 4 models for integrating primary care into cancer survivorship programs and has outlined the advantages and disadvantages of each model.
 
Models range from survivorship care “expert” PCPs offering either comprehensive continuity of care or consultative care in a cancer center, to designated PCPs in local practices, to community-based PCPs without specific survivorship expertise.
 
According to Dr. Nekhlyudov, the increasing population of cancer survivors necessitates more efficient management of their cancer and noncancer-related needs and would benefit from the involvement of primary care providers. Evaluation of innovative models of cancer survivorship care is clearly needed.
 
To read a subsequent interview with Dr. Nekhlyudov in the ASCO Post click here.