A qualitative study of care management challenges in patients with multiple sclerosis from patient, family caregiver and healthcare provider perspectives

Abstract Multiple sclerosis (MS) is a chronic and disabling disease requiring continuous, coordinated, and multidimensional care. Despite advances in MS management, people with MS and their families continue to encounter barriers throughout the care process. This study explored challenges in MS care management from the perspectives of patients, family caregivers, and healthcare providers. This descriptive qualitative study was conducted in Iran between 2024 and 2025. We purposively sampled participants and collected data through 50 semi-structured interviews with people with MS, family caregivers, and healthcare providers. We analysed the data inductively using Graneheim and Lundman’s qualitative content analysis approach, using MAXQDA 2020 for data management. Inductive analysis generated two main categories and ten subcategories. The first, “Structural and Professional Challenges in MS Care,” included limitations in insurance policies and service coverage, inadequate professional training, weak interprofessional coordination, organisational and resource challenges, and professional strain. The second, “Challenges Related to Patients and Families in MS Care,” covered financial, psychosocial, occupational, cultural, informational, and physical barriers to care. MS care management is challenged by interconnected barriers across health-system, professional, patient, and family levels. Addressing these challenges may benefit from comprehensive strategies encompassing healthcare system improvements, interprofessional coordination, education and training for healthcare professionals, patients, and caregivers, financial support, culturally appropriate care, and improved access to supportive services. Such an approach may help strengthen continuity and coordination of MS care and better address the diverse needs of people with MS and their families.