Bahrain primary care physicians show multiple sclerosis gaps

Primary care physicians in Bahrain demonstrate strong baseline knowledge of multiple sclerosis characteristics but face significant gaps in diagnosing and managing relapses, according to a cross-sectional study published in BMC Neurology in 2026.

Survey Results Reveal Strong Demographics Understanding Against Low Criteria Familiarity

Out of 428 invited primary care physicians, 211 completed the questionnaire for a 49.3% response rate. Respondents correctly identified immune-mediated central nervous system involvement, female predominance at 67.3%, peak ages between 20 and 40 years, and relapsing-remitting multiple sclerosis as the most common subtype in 60.2% of answers. Magnetic resonance imaging was selected as the preferred initial investigation by 75.8% of participants. However, while 52.6% understood that diagnosis requires dissemination in time and space, only 7.6% reported familiarity with the McDonald criteria.

Relapse Management Deficiencies Complicate Primary Care Treatment Pathways

Gaps extended directly into relapse assessment and therapeutic intervention. Although 76.8% recognized that a relapse involves new or worsening neurological symptoms, only 33.7% knew that symptoms must persist for at least 24 hours. Furthermore, just 44.5% understood that at least 30 days should separate distinct relapses, and only 41.2% identified methylprednisolone 500 to 1000 mg as the recommended initial treatment. More than half of respondents reported complete unfamiliarity with disease-modifying therapies, though interferon beta was recognized by 64.7% of those claiming knowledge.

Specialist Collaboration and Targeted Education Proposed for Bahrain Health Centers

Higher knowledge scores mapped directly to attendance at multiple sclerosis conferences, seminars, or workshops, greater patient exposure, and self-reported knowledge sufficiency. Researchers recommended focused educational initiatives addressing diagnosis, relapse protocols, and disease-modifying therapies alongside stronger collaboration between primary care doctors and multiple sclerosis specialists. Meanwhile, a review published in sciencedirect.com emphasized that primary care providers act as essential first-line responders for monitoring disease activity, managing comorbidities, and supporting imaging surveillance when patients face travel constraints to distant tertiary care centers.