Background: People with multiple sclerosis (MS) have a higher prevalence of osteoporosis (27% vs 12.6%) and onset occurs at a younger age (41.5yrs±7.9) when compared to the general population (>50 years). MS-related osteoporosis and poor bone health are under-recognised and managed in people with MS, and if not managed well, it may reduce independence and impair quality of life.
Aim: This study aimed to assess the healthcare professionals who are part of the multidisciplinary care team for people with MS about their knowledge, current practices, barriers and enablers to bone health management in MS.
Methods: Participants were 30 healthcare professionals, including: neurologists (4), endocrinologists (8), MS nurses (9), general practitioners (5), and physiotherapists (4), recruited through network contacts. Participants were interviewed using a semi-structured script (mean: 26min, range: 17.8 – 33.1min). Interviews were undertaken and recorded using Zoom. Transcription was performed using Otter.ai and reviewed for accuracy by the interviewing researcher (LAJ). Transcripts were coded in NVivo Plus (v12) using framework analysis.
Results: Most participants with experience in managing people with MS acknowledged the higher risk of osteoporosis compared with the general population. Apart from the endocrinologists and nurses, many participants reported limited bone health knowledge in people with MS which hindered proper bone health management. MS-related priorities overshadowed bone health concerns. Many endocrinologists and half of the general practitioners found bone health management practices in MS insufficient, and some endocrinologists were uncertain of best practice for people with MS. Improved clinician and patient educational materials were recommended.
Conclusion: There is a clear need for greater proactive management of bone health in people with MS. This would be supported by guidelines for managing bone health in MS and development of educational resources for people with MS and healthcare professionals.