Understanding the Barriers to Effective Bone Health Management in People With Multiple Sclerosis

Background: The prevalence of osteoporosis is higher in people with multiple sclerosis (MS) compared with the general population. Poor bone health, including higher rates of osteopenia and osteoporosis than in the general population, has been established in people with MS. This qualitative study examines how much a group of health care professionals (HCPs) knows about osteoporosis as an MS comorbidity, as well as current practices, barriers to effective bone health management in people with MS, and recommendations for improvement. Methods: Thirty-two Australian HCPs participated in qualitative interviews, including 4 neurologists, 8 endocrinologists, 9 MS nurses, 6 general practitioners, and 5 physiotherapists. Participants were recruited via email, phone calls, and network contacts. Due to a technical error with the recording of 1 interview, 31 interviews were transcribed using Otter.ai. They were reviewed for accuracy and analyzed through NVivo using framework analysis. Results: Most clinicians lacked specific knowledge regarding bone health in people with MS. While the heightened osteoporosis risk in people with MS was presumed, participants perceived current practices as insufficient or were uncertain about their adequacy. Lack of awareness and education about bone health in people with MS emerged as primary barriers, as did insufficient interdisciplinary communication, role delegation, funding, and resources, which were deemed essential for better management. Conclusions: Clinicians advocated for specific guidelines, enhanced education for HCPs, increased resources for patients and clinicians, and improved access to bone health screening for people with MS. These findings underscore the need for comprehensive strategies, emphasizing collaboration, education, and resource allocation, to address the complexities of bone health in individuals with MS.