Adapting to life with chronic migraine: a qualitative study of lived experiences among multi-ethnic Asian patients

Background: Chronic migraine is associated with greater disability, productivity losses and reduced quality of life compared to episodic migraine. Limited research has explored the multi-faceted burden of chronic migraine from patients' perspectives and experiences, particularly in the Asian context. This study aims to explore the burden of chronic migraine through the lived experience of multi-ethnic Asian patients and to identify gaps in migraine awareness, service provision and clinical management. Methods: This was a qualitative study design involving semi-structured interviews with patients with chronic migraine recruited from a Neurology outpatient clinic in a large tertiary hospital in Singapore. Data was collected through face-to-face interviews and transcribed verbatim. Inductive thematic analysis was performed to identify key themes. Results: 17 participants with chronic migraine took part in the study. 4 main themes were identified which illustrate the substantial burden of chronic migraine: 1) Living with migraine long-term; 2) Dealing with stigma; 3) Navigating the healthcare journey; and 4) Regaining agency and validation. Participants described physical, psychosocial and financial consequences that disrupted their daily roles and sense of self. Stigma and the invisibility of chronic migraine compounded this burden. Participants demonstrated strong efforts to regain agency through lifestyle modifications, complementary therapies and peer support, despite limited treatment options and persistent uncertainty. Conclusion: This study provided insights into the lived experience of chronic migraine among multi-ethnic Asian patients. Our findings highlight the importance of culturally sensitive and patient-centred approaches that validate patients' experiences, address stigma, and integrate psychosocial as well as medical needs.