Social burden of multiple sclerosis in Georgia: analysis of patients and caregivers

Abstract Background Multiple sclerosis (MS) presents a significant social burden globally, with varying impacts in different regions. The study assessed MS burden in Georgia, through the evaluation of patient's and caregivers’ quality of life and sociodemographic factors. Methods Cross-sectional study (May-December 2023) assessed 384 MS patients and 385 caregivers using internationally validated questionnaires measuring physical, mental, and social burden. Results MS patients had a high unemployment (43%). Urban residents reported a better quality of life than rural counterparts (p < 0.001). Patient Expanded Disability Status Scale (EDSS) scores negatively correlated with physical health (r=-0.249, p < 0.001) and overall quality of life (r=-0.220, p < 0.001). A big majority of caregivers (77.9% female), reported physical impacts and mental health challenges. Urban caregivers experienced a higher burden (physical: 96.2%, p < 0.001; mental: 72.8%, p < 0.001). Male caregivers reported higher social burden (82.4% vs 59.7%, p < 0.001). Substantial health literacy gaps were identified, with 52.2% of caregivers lacking knowledge about disease. Caregivers of untreated patients experienced a higher burden across all domains (p < 0.001). The social burden of MS extends beyond direct healthcare costs, including productivity loss. Conclusions This study reveals critical public health challenges: economic impact through unemployment, urban-rural disparities, gender inequities, and health literacy gaps. The findings underscore the need for tailored public health interventions, a national MS registry, and improved access to multidisciplinary care and support services to address the complex social burden of MS in Georgia. Key messages • MS creates public health challenges through high unemployment and caregiver burden, requiring targeted policy interventions. • Urban-rural and gender disparities represent critical social determinants necessitate equitable healthcare access and tailored support programs.