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Access and barriers to diagnosis of multiple sclerosis in Iran - A clinician survey
Sanaz Khodadadi1, Sahar Nikkhah Bahrami1, Shima Jahani1
1Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Background:
Timely diagnosis of multiple sclerosis (MS) is critical for optimal outcomes, but delays are common, particularly in resource-limited settings. This study investigates the barriers to MS diagnosis in Iran from the perspectives of neurologists.
Methods:
A cross-sectional study was conducted using a questionnaire adapted from the MS International Federation (MSIF) Atlas of MS, 3rd Edition, and the 2024 Topical Survey, administered via an online platform to Iranian neurologists. Data collection occurred from April 1, 2024, to June 30, 2024.
Results:
The survey received responses from 103 neurologists (34.1 % response rate), of whom 64 were general neurologists (GN) and 39 were MS specialists (NMS). Eighty percent reported at least one 'major barrier' to early MS diagnosis. These barriers included a lack of public (43.7 %) and healthcare provider (37.9 %) awareness of MS symptoms and patient reluctance to undergo testing due to social stigma (77.3 %). Access to paraclinical testing, including visual evoked potentials (VEP), optical coherence tomography (OCT), MOG-IgG, and AQP4-IgG testing, was variable. Most respondents (98.05 %) reported adherence to national guidelines, yet 4 % of NMS and 16 % of GN reported that they did not use the McDonald criteria.
Conclusions:
Barriers to timely MS diagnosis in Iran are multifactorial, involving public awareness, healthcare professional education, and access to adequate resources. Addressing these issues through targeted education and improved infrastructure is essential.
