Salimah H. Meghani, PhD, MBE, CRNP, RN
Assistant Professor of Nursing
By focusing on racial and ethnic disparities in pain treatment, Penn Nursing Professor Dr. Salimah Meghani is working to address pain management in low-income and minority patients. Although minority patients often suffer more severe pain and physical impairments than non-minority patients and are more likely to perform potentially harmful physical work, they are even less likely to receive guideline-recommended pain treatment in virtually all healthcare settings in the U.S.
According to recent estimates, chronic pain affects 116 million American adults and it remains the number one reason people seek medical care. The burden of pain on Americans in direct and indirect costs can reach $635 billion annually. While the actual cost of pain treatment disparities in the U.S. has not been quantified, Dr. Meghani and colleagues anticipate this cost to be large given the magnitude of pain under-treatment among minorities and underserved.
"There is no question that pain treatment disparities matter in many significant ways," says Dr. Meghani. "The most important are the tremendous burdens placed on patients, health systems, and society when the most effective pain care is not accessible, affordable, and delivered to those in need."
Recently in Pain Medicine, The Official Journal of the American Academy of Pain Medicine
, Dr. Meghani published two important reports. The first report synthesized 20 years of cumulative evidence on racial/ethnic disparities in the prescription of pain medications in the United States quantifying magnitude of these disparities for subgroups of minorities. Dr. Meghani and co-authors from Penn Nursing and Philadelphia VA Medical Center found that African Americans experienced significantly higher number and magnitude of disparities than any other racial or ethnic group in the analysis. Of concern, the authors note that the pain treatment gap for African Americans is not closing with time or important policy initiatives including the Joint Commission mandate to improve assessment and treatment of pain.
In a second report, Dr. Meghani and a nationally renowned group of experts identified concrete opportunities for achieving equity in pain care for minorities; especially those occasioned by the Affordable Care Act
. The authors proposed broad advocacy initiatives such as “Look at the Data Campaigns©,” intended to sensitize providers to blind spots that contribute to inequitable pain care, emphasizing the need for targeted education in pain disparities as part of graduate and continuing medical education, as well as in licensure, accreditation, and certification programs for medicine, nursing, and allied health professionals.
Advancing a National Agenda to Eliminate Disparities in Pain Care: Directions for Health Policy, Education, Practice, and Research
Time to take stock: A Meta-Analysis and systematic review of pain treatment disparities in the United States