Different Experiences in Chronic Migraine Etiology, Treatment and Comorbidities of Hawaii’s Ethnic Groups (P14-12.006)

Abstract

<h3>Objective:</h3> To determine racial disparities in CM treatment and comorbidities of patients in Hawaii, a state characterized by its a majority-minority patient population. We hypothesize that minority populations are under-treated. <h3>Background:</h3> Chronic migraine (CM) is a debilitating condition with negative repercussions on the socioeconomic status of patients; compounded by under-diagnosis and treatment in minority populations. Identifying treatment and comorbidity characteristics of CM patients in Hawaii will guide treatment of migraines. <h3>Design/Methods:</h3> We performed a retrospective chart review on patients diagnosed with CM at a headache and facial pain center in Honolulu, Hawaii. 743 patients with a clinic visit from January 27, 2022 to April 27, 2022 were retrieved from <i>eClinicalWorks</i>. Patients without sufficient data were excluded, yielding 298 patients fulfilling inclusion criteria of a) ICD-10 code diagnosis of CM b) lack of secondary migraine etiology and c) fulfilling IHCD-3 standards of CM. Socioeconomic demographic variables were collected including self-reported race, age, obesity, number of medications and public/private health insurance. Patient treatment modalities were recorded: botulinum toxin (BoNT), pharmacologic treatment, monoclonal antibodies, and physical therapy. <h3>Results:</h3> Native Hawaiian/Pacific Islander (NHPI) patients reported the highest prevalence of obesity (60.9%) at &gt;30% compared to other race groups (p&lt;0.001). History of diabetes was low across all race groups (7.7%). However, NHPI patients had a higher history of diabetes (14.5%) (p= 0.004), hypertension (37.7%), &gt;13% higher than other race groups (p= 0.01). Significantly more white patients received BoNT as therapy (73.9%), &gt;25% compared to other race groups (p= 0.02). Public insurance was significantly more common in NHPI patients (59.4%) followed by other minorities (57.1%), with a 9–11% difference compared to other race groups. (p=0.02) <h3>Conclusions:</h3> Our findings suggest barriers to BoNT treatment in minority patients. Comorbidities in NHPI patients, such as obesity, diabetes and hypertension, differ from other ethnic groups. <b>Disclosure:</b> Miss Lu has nothing to disclose. Ms. Yamane has nothing to disclose. Mr. Keahi has nothing to disclose. Mr. Tong has nothing to disclose. Mr. Goo has nothing to disclose. The institution of an immediate family member of Ms. Prabhudesai has received research support from National Eye Institute. An immediate family member of Ms. Prabhudesai has received intellectual property interests from a discovery or technology relating to health care. The institution of Dr. Chen has received research support from NIH. Dr. Vajjala has nothing to disclose. Enrique Carrazana has received personal compensation for serving as an employee of Neurelis. Enrique Carrazana has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Neurelis, Alexza, Zogenix. Enrique Carrazana has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Hawaii-Biotech, CND Life Sciences. Enrique Carrazana has stock in Neurelis, Marinus, . Dr. Viereck has nothing to disclose. The institution of Dr. Liow has received research support from UCB. The institution of Dr. Liow has received research support from Livanova. The institution of Dr. Liow has received research support from Biogen. The institution of Dr. Liow has received research support from Novartis. The institution of Dr. Liow has received research support from Eisai. The institution of Dr. Liow has received research support from Engage Therapeutics. The institution of Dr. Liow has received research support from SK Lifescience. The institution of Dr. Liow has received research support from Cerevel. The institution of Dr. Liow has received research support from Xenon. The institution of Dr. Liow has received research support from NeuroDerm. The institution of Dr. Liow has received research support from Avanir. The institution of Dr. Liow has received research support from Annovis. The institution of Dr. Liow has received research support from Acadia.