# Knowledge and Clinical Practice Regarding Multiple Sclerosis Among Family Physicians in the First Health Cluster, Riyadh

## TL;DR

This study assesses family physicians' knowledge and clinical practices regarding multiple sclerosis in Riyadh, finding gaps in understanding and confidence.

## Contribution

The study provides insights into MS knowledge gaps and referral practices among family physicians in Saudi Arabia.

## Key findings

- Over half of physicians had high or moderate knowledge of MS, but misconceptions about prognosis and pregnancy effects were common.
- Most physicians referred MS patients immediately, citing long waiting times and limited neurologist availability as barriers.
- Low confidence in managing MS symptoms and minimal diagnostic work-up initiation were reported.

## Abstract

Background

The timely diagnosis of multiple sclerosis (MS) and patient referral in primary care are important. However, evidence on knowledge and clinical practice regarding MS among family physicians in Saudi Arabia (SA) is limited. This study aimed to assess knowledge and clinical practice regarding MS among family physicians in the First Health Cluster in Riyadh, SA.

Methodology

A cross-sectional study was conducted from May to December 2025. A total of 145 family physicians in hospitals and primary care centers have been recruited. Data were collected using a validated self-administered questionnaire on demographic characteristics and MS knowledge. Descriptive statistics and the chi-square test were used to explore associations between knowledge level and professional characteristics.

Results

Approximately 75 (51.7%) of participants showed high knowledge, and 64 (44.1%) had moderate knowledge. Common misconceptions were identified, particularly regarding the impact of MS on life expectancy 86 (59.3%) and the effects of pregnancy on MS 85 (58.6%). A total of 74 (51.0%) physicians reported seeing 1-5 patients with MS annually, whereas 65 (44.8%) had never encountered a patient with MS. Most physicians 86 (59.3%) preferred immediate referral. A low proportion of participants were confident in their ability to manage symptoms. Reported referral barriers included long waiting times (118; 81.4%), limited neurologist availability (58; 40.0%), and geographic distance (35; 24.1%).

Conclusions

There were significant gaps in prognosis and pregnancy-related knowledge, along with low confidence in symptom management and minimal initiation of work-up. These findings support targeted training, specifically for family medicine residency programs, the incorporation of MS-focused modules into residency curricula, and the development of national guidelines to strengthen MS care.