Salimah Meghani’s Research Uncovers Disparities and Provider Biases
Findings show provider biases may operate despite presence of clinical risks.
New research by Salimah H. Meghani, PhD, MBE, RN, FAAN, Associate Professor of Nursing, which investigated heuristics underlying cancer pain treatment decision-making for African Americans and whites, has uncovered disparities in that treatment and possible sources of these disparities. Her research has been published in the Journal of Clinical Oncology and has received coverage from other medical media including the American Society of Clinical Oncology, ReutersHealth and Medscape from WebMD.
Her study, "African Americans With Cancer Pain Are More Likely to Receive an Analgesic With Toxic Metabolite Despite Clinical Risks: A Mediation Analysis Study," found that African American cancer patients with renal impairment were more likely to be prescribed morphine to control pain, even though morphine has toxic metabolites that accumulate in the presence of kidney disease. White cancer patients were significantly more likely to be prescribed the safer choice of opioid, oxycodone. Even after controlling for health insurance type, African-Americans had a 71 percent lower chance of receiving oxycodone than white patients. Dr. Meghani’s findings are unique in that they show that provider biases may operate despite presence of clinical risks.
Her study also uncovered that side effects of morphine were a possible reason why African Americans are less likely to adhere to pain medications despite moderate-to-severe cancer pain.
Dr. Meghani is an associate professor in the Department of Biobehavioral Health Sciences and a core member of the NewCourtland Center for Transitions and Health at Penn Nursing, and an Associate Fellow of the Center for Bioethics at the University of Pennsylvania. Her research focuses on understanding and addressing sources of disparities in pain treatment among vulnerable populations in order to narrow the gap in pain-related clinical outcomes among racially and economically disparate groups. Her research is funded by the National Institutes of Health, the American Cancer Society/Abramson Cancer Center IRG; Institute of Aging/Penn Minority Aging Research for Community Health; Center for Health Equity Research and Promotion; Oncology Nursing Society Foundation; and Ortho-McNeil Janssen Scientific Affairs.