Multiple sclerosis diagnosis delay and its associated factors among Iranian patients

OBJECTIVE A long diagnostic delay in multiple sclerosis (MS) reduces the chance of early access to disease modifying therapies with potential to impact on disease trajectory. The aims of this study were to determine the delay in diagnosis of MS and its associated factors in Iran. METHODS Our study was conducted on 536 MS patients who were selected from Multiple sclerosis registry database and neurology clinics in southern part of Iran. Data were collected via a face-to-face interview administered questionnaire. A multiple linear regression model was used to control for the effect of potential confounding factors on the delay of MS diagnosis. RESULTS The mean of diagnostic delay was 7.0 months. Single patients were diagnosed on average 1.33 months later compared with those who were married (P = 0.007). Those who were registered with a family physician reported an average of 1.42 months longer delay in diagnosis than others (P = 0.004). For each year of older age at diagnosis, the delay was 1.04 months longer (P < 0.001). On the other hand, those who had migraine were diagnosed 1.58 months earlier than others (P < 0.001). Participants with a vision problem as the initial symptom were diagnosed 1.48 months earlier than those with sensory symptoms (P < 0.001), and 1.28 months earlier than those with headache/dizziness (P = 0.093). It was also suggested that the diagnostic delay was shortened over the study period (on average 1.06 months per year, P < 0.001). CONCLUSION Easy access to a neurologist, raising health literacy in the general population, and improving the family physicians' alertness about MS symptoms can shorten the delay of MS diagnosis.