# Physicians' Perspectives on Barriers to Multiple Sclerosis Care in the United Arab Emirates: A Survey Study

## TL;DR

This study explores challenges in Multiple Sclerosis care in the UAE from neurologists' perspectives, highlighting issues like cost, insurance, and system gaps.

## Contribution

The study provides new insights into barriers to MS care in Abu Dhabi, focusing on physician perspectives and gender differences.

## Key findings

- High medication costs and insurance issues are major barriers to MS care.
- Private institutions show gaps in monitoring and support practices.
- Gender differences in perceived barriers are statistically significant.

## Abstract

Introduction: Multiple Sclerosis care in the United Arab Emirates faces several barriers impacting patient outcomes and healthcare delivery. This study aims to identify and analyze these barriers from the perspective of neurologists.

Methods: In February 2024, a survey was conducted targeting neurologists involved in Multiple Sclerosis management in Abu Dhabi. The survey included questions on demographics, regularly measured clinical variables, perceived barriers, and contributing factors. A total of 21 neurologists responded, and data were analyzed to identify prevalent issues and correlations.

Results: Among the 21 respondents, 15 (71.4%) were male, and 15 (71.4%) were from private institutions. Most neurologists regularly advised on vitamin D level monitoring (16, 76.2%) and psychological support (15, 71.4%). Screening for disease-modifying treatment side effects, Expanded Disability Status Scale assessments, and magnetic resonance imaging comparisons were practiced, but improvement is needed, especially in private settings (10, 47.6%). Significant barriers identified included the high cost of medications (11, 52.4%), insurance-related issues (10, 47.6%), and socioeconomic factors (9, 42.9%). Physician-related barriers, such as time constraints (8, 38.1%) and lack of specialist nursing support (4, 19.0%), were also prominent. System-related barriers included insurance provider policies (13, 61.9%) and gaps in clinical guideline coverage (11, 52.4%). Gender differences in perceived barriers were significant (p=0.016), while age was not (p=0.147).

Conclusions: This study highlights critical barriers to Multiple Sclerosis care in Abu Dhabi, emphasizing the need for policy changes, improved insurance coverage, and targeted support for patients and healthcare providers. Addressing these barriers is essential for enhancing the region's quality of Multiple Sclerosis care and patient outcomes.