University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Internal Medicine - Hematology


Larry Herman, DMSc, MPA, PA-C, DFAAPA



Sickle cell disease (SCD) is one of the most common inherited diseases associated with lifetime morbidity and reduced life expectancy. SCD affects mainly African Americans and, to a lesser degree, Hispanic Americans. In general, these populations are known to have healthcare disparities related to lower socioeconomic status, inferior access to healthcare, and racial bias. The life expectancy of those with SCD is less than 50 years of age due to many preventable complications. However, their quality of life is impacted, and they are afflicted with years of managing daily chronic pain. The most common complication is severe pain episodes known as acute pain crises related to vaso-occlusive ischemic events. Although guidelines exist, delayed pain management is the norm as patients combat resistance from clinicians concerned with opioid use or abuse, overdose, or concern for drug-seeking behavior. Effective pain management can be accomplished with collaboration between clinicians and patients, a documented outpatient pain management plan, and, when necessary, by an emergency department clinical pain pathway for acute SCD pain management.


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