Jenna Tsuzaki,1,2 Sarah Dao,1 Asja Deai,1 Tiara Harris,1 Maya Kimura,1 Janette Bow-Keola,2 Tyrone Sumibcay,1,2 Matthew Kao,1,2 Masako Matsunaga,2 Eonjung Angeline Kim,1 Natalia Gonzalez,1 Enrique Carrazana,2 Kore Liow1,2
1 Spine & Pain Management Center, Hawaii Pacific Neuroscience, Honolulu, HI
2 John A. Burns School of Medicine, University of Hawaiʻi, Honolulu, HI
Introduction: The objective of this study is to characterize the prevalence of migraine triggers, explore sociodemographic and clinical associations with migraine burden in a Hawaii based outpatient population.
Methods: A retrospective EMR review under the ICD of “migraine” was collected from 2015-2025. Variables collected included demographics, migraine characteristics at initial and most recent visit, triggers, comorbidities, medication use, outcomes, and trigger specificity.
Results: A total of 155 patient records were analyzed. Pain was more commonly reported in chronic migraines (11%) compared to episodic (1.4%) (p=0.019). Preventive medication use was also significantly higher among chronic migraine patients (73%) compared to episodic (52%) (p=0.007). Chronic migraine patients had a significantly higher number of comorbidities compared to episodic patients (p=0.004). Sleep disorders and chronic pain were more prevalent in chronic migraines (22% and 12%) compared to episodic ( 8.2% and 2.7%) (p=0.018, p=0.028). Patients with public health insurance reported longer episode duration (1,440min/episode) than those with private (360 min/episode) (p=0.040). Migraine pain severity was associated with ethnicity, with “Other”, “Unknown” and Asians reporting higher ratings compared to NHPI and White populations (p=0.034).
Conclusions: Chronic migraine was associated with greater comorbidity burden and higher preventive medication use. Sociodemographic factors were associated with migraine severity and duration. These findings emphasize the importance of improved EMR documentation in identifying disparities to create targeted care in diverse populations such as Hawaii.
