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The Migraine Care Gap: A Qualitative Analysis of Patients' Perspectives on Medical Progress and Persistent Unmet Needs

Göbel CH, Zimmermann M, Heinze A, Heinze-Kuhn K, Cirkel A, Göbel H

Pain and therapy, 2026

Abstract

Introduction: Despite remarkable advances in migraine diagnosis and treatment, it remains unclear to what extent these developments have translated into meaningful improvements in the everyday lives of people living with migraine. This qualitative study explored how patients perceive the evolution of migraine care over the past decade and identified persistent unmet needs from their perspective.

Methods: A qualitative exploratory study was conducted using reflexive thematic analysis. The dataset comprised 446 publicly available patient narratives posted in response to an Instagram Reel and a corresponding Facebook post inviting individuals with migraine to reflect on changes in migraine care over the previous 12 years. Comments describing personal experiences with diagnosis, treatment, healthcare delivery, social participation and future expectations were analysed inductively following the methodological framework proposed by Braun and Clarke.

Results: Analysis identified four overarching conceptual domains. Participants consistently acknowledged substantial progress in migraine medicine, particularly through migraine-specific acute therapies, calcitonin gene-related peptide (CGRP)-targeted preventive treatments, specialised headache services and improved access to disease-related information. However, these advances were perceived as only partially reflected in clinical practice and everyday life. Persistent barriers included delayed diagnosis, unequal access to specialised…

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