Assessing Unmet Social Needs in Multiple Sclerosis Care in Australia: A Qualitative Assessment of Feasibility, Barriers and Enablers

BACKGROUND: Unmet social needs (including housing, transport and social inclusion) contribute substantially to health outcomes, especially for people with long-term health conditions such as multiple sclerosis (MS). Whether assessment of unmet social needs occurs in MS clinical care is unclear. This study aims to (1) understand current practices, (2) identify barriers and enablers to social needs assessments in MS care, and (3) explore the feasibility of social needs screening tools. METHODS: This qualitative descriptive study comprised focus groups and interviews with clinicians, carers and people with MS in Australia. We inductively and deductively coded transcripts and used applied thematic analysis to identify themes, using COM-B (Capability, Opportunity, Motivation, Behaviour) and Feasibility frameworks. RESULTS: We collected data from 19 participants (11 clinicians and 8 lived-experience participants). Participants reported inconsistent and unstructured social needs assessment in MS care. Barriers aligned with capability (lack of referral pathway knowledge), opportunity (resources) and motivation (belief in abilities, evidence of value and scepticism). Enablers aligned with capability (clinician rapport and self-advocacy), opportunity (care coordination and self-paced assessment), and motivation (mutual desire for positive patient outcomes). A social needs screening tool was considered acceptable, conditional on adequate resourcing and/or design to ensure identified needs can be addressed. CONCLUSION: Findings from this qualitative descriptive study suggest that the current integration of social care in MS healthcare in Australia is inadequate. We identified opportunities to develop and test a screening tool and supporting referral resources to identify and address unmet social needs in MS patients. Better integrated social and healthcare represents a promising avenue for improving comprehensive MS management.