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Research ArticleOriginal Article
Open Access

Do people with multiple sclerosis in Saudi Arabia want to know their prognosis? A cross-sectional nationwide study

Yaser M. Al Malik, Awad S. Alharbi, Mohammed A. Alfurayh, Abdulaziz A. Aldalaan, Abdulazeez M. Alzailaie, Eid D. Alanazi, Ahmad A. Abulaban, Seraj O. Makkawi and Asma A. Alanazi
Neurosciences Journal April 2025, 30 (2) 108-116; DOI: https://doi.org/10.17712/nsj.2025.2.20240094
Yaser M. Al Malik
From the College of Medicine (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), from the Department of Neurology (Al Malik, Abulaban), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, from College of Medicine (Makkawi), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Makkawi), and from the Department of Neuroscience (Makkawi), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Jeddah, Kingdom of Saudi Arabia
MBBS, FRCPC
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  • For correspondence: [email protected]
Awad S. Alharbi
From the College of Medicine (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), from the Department of Neurology (Al Malik, Abulaban), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, from College of Medicine (Makkawi), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Makkawi), and from the Department of Neuroscience (Makkawi), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Jeddah, Kingdom of Saudi Arabia
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Mohammed A. Alfurayh
From the College of Medicine (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), from the Department of Neurology (Al Malik, Abulaban), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, from College of Medicine (Makkawi), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Makkawi), and from the Department of Neuroscience (Makkawi), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Jeddah, Kingdom of Saudi Arabia
MBBS
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Abdulaziz A. Aldalaan
From the College of Medicine (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), from the Department of Neurology (Al Malik, Abulaban), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, from College of Medicine (Makkawi), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Makkawi), and from the Department of Neuroscience (Makkawi), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Jeddah, Kingdom of Saudi Arabia
MBBS
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Abdulazeez M. Alzailaie
From the College of Medicine (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), from the Department of Neurology (Al Malik, Abulaban), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, from College of Medicine (Makkawi), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Makkawi), and from the Department of Neuroscience (Makkawi), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Jeddah, Kingdom of Saudi Arabia
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Eid D. Alanazi
From the College of Medicine (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), from the Department of Neurology (Al Malik, Abulaban), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, from College of Medicine (Makkawi), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Makkawi), and from the Department of Neuroscience (Makkawi), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Jeddah, Kingdom of Saudi Arabia
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Ahmad A. Abulaban
From the College of Medicine (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), from the Department of Neurology (Al Malik, Abulaban), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, from College of Medicine (Makkawi), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Makkawi), and from the Department of Neuroscience (Makkawi), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Jeddah, Kingdom of Saudi Arabia
MBBS, SBN
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Seraj O. Makkawi
From the College of Medicine (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), from the Department of Neurology (Al Malik, Abulaban), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, from College of Medicine (Makkawi), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Makkawi), and from the Department of Neuroscience (Makkawi), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Jeddah, Kingdom of Saudi Arabia
MBBS, FRCPC
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Asma A. Alanazi
From the College of Medicine (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Al Malik, Alharbi, Alfurayh, Aldalaan, Alzailaie, Alanazi, Abulaban, Alanazi A), from the Department of Neurology (Al Malik, Abulaban), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, from College of Medicine (Makkawi), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Makkawi), and from the Department of Neuroscience (Makkawi), King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Jeddah, Kingdom of Saudi Arabia
PhD
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  • Article
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Article Figures & Data

Tables

    • View popup
    Table 1

    - Socio-demographic characteristics of the sample (n=375).

    VariablesNumberPercent
    Age   
    Mean33.99 
    SD8.87 
    20 or less143.7
    21– 3012834.1
    31 – 4016243.2
    41 – 505213.9
    51 and up195.1
    Gender   
    Male13736.5
    Female23863.5
    Education   
    Primary or Secondary5514.7
    Occupational/diploma University4311.5
    University or postgraduate26871.5
    Other92.4
    Marital Status   
    Married21457.1
    Not married16142.9
    Nationality   
    Saudi35193.6
    Non-Saudi246.4
    Region   
    Central Region16644.3
    Eastern Region6216.5
    Western Region8823.5
    Southern region3810.1
    Northern region215.6
    Occupation   
    Employed/self-employed (full or part-time)17847.5
    Not working due to sickness or disability6918.4
    Retired246.4
    Other10427.7
    • View popup
    Table 2

    - MS History among the Subjects in the Sample (n=375).

    VariablesNumberPercent
    MS type   
    RRMS26971.7
    SPMS4913.1
    PPMS5715.2
    Duration since diagnosis (in years)   
    Mean8.59 
    SD6.50 
    5 or less14739.2
    6-1010528.0
    11-2010728.5
    21 and up164.3
    Duration since the onset of symptoms (in years)   
    Mean9.61 
    SD6.62 
    5 or less11229.9
    6-1012032.0
    11-2012232.5
    21 and up215.6

    MS - Multiple Sclerosis, RRMS - Relapsing Remitting MS, SPMS - Secondary Progressive MS, PPMS - Primary progressive MS

      • View popup
      Table 3

      - Frequency distribution of MS long-term prognosis as reported by the subjects in the sample (N= 375).

      VariablesNumberPercent
      “During your consultation with your Neurologist, has your long-term prognosis ever been addressed?”   
      No256(68.3)
      Yes119(31.7)
      “During your appointments, who introduced you the discussion of long-term prognosis?”   
      The patient43(11.5)
      Neurologist86(22.9)
      Multiple Sclerosis specialist nurse5(1.3
      GP5(1.3)
      Other health care professional5(1.3
      Family member or friend7(1.9)
      Don’t know / can’t remember11(2.9)
      Nobody256(70.5)
      “Which healthcare professionals gave you different messages when your long-term prognosis was addressed?”   
      Different neurologists gave different messages.88(23.5)
      Different GPs gave different messages.31(8.3)
      Nobody256(68.3)
      “Do you well-understand your long-term prognosis?”  
      I have no idea at all248(66.1)
      I have a very rough idea (give or take 20 years)48(12.8)
      I have a rough idea (give or take 10 years)39(10.4)
      I have an accurate idea (give or take 5 years)15(4.0)
      I have a very accurate idea (give or take 2 years)25(6.7)
      “At the moment, please rate how eager you are to identify your long-term prognosis.”   
      A lot231(61.6)
      A little41(10.9)
      I do not want to know70(18.7)
      Not sure33(8.8)
      “The moment your diagnosis was provided, please rate how eager you are to identify your long-term prognosis.”   
      A lot225(60.0)
      A little59(15.7)
      I would not have wanted to know58(15.5)
      Not sure33(8.8)
      “In the years to come, please rate how eager you are to identify your long-term prognosis.”   
      A lot224(59.7)
      A little52(13.9)
      I would not have wanted to know58(15.5)
      Not sure41(10.9)
      Approximately how often you contemplate about your long-term prognosis?   
      Daily108(28.8)
      Weekly69(18.4)
      Monthly54(14.4)
      Once a year22(5.9)
      Rarely89(23.7)
      Never33(8.8)
      “By the following people, have you ever addressed your long-term prognosis with them?”   
      Partner or spouse74(19.7)
      Parents53(5.3)
      Children16(4.3)
      Other family members67(17.9)
         
      Friends88(23.5)
      Colleagues at work10(2.7)
      Employer9(2.4)
      No-one210(56.0)
      “Does it will influence your current decision if you will learn an accurate long-term prognosis?”   
      Treatment249(66.4)
      Relationships117(31.2)
      Family planning (i.e. if and when to have children)86(22.9)
      Job matters202(53.9)
      Financial planning162(43.2)
      Drawing up a will61(16.3)
      End-of-life decisions (e.g. instructions about medical interventions if you became very ill or disabled)148(39.5)
      • View popup
      Table 4

      - MS oatients’ attitudes towards prognosis forecasting tools (N=375).

      VariablesNumberPercent
      “Do you want to be notified about the availability of this tool during your medical appointment if this tool is successfully created?”   
      Yes32185.6
      No5414.4
      “What is the timeline you prefer to avail the prognosis tool?”   
      At diagnosis30681.60
      A few weeks or months after diagnosis5213.87
      When you need to make a treatment decision11530.67
      When you need to make a life decision10327.47
      At other times92.40
      Never349.07
      “Learning your long-term prognosis by using this tool, which of the following setup would you agree?”   
      I use the software myself, on my own13134.9
      Use the software myself, accompanied by a significant other)9826.1
      With a neurologist, unaccompanied by a significant other15942.4
      With a neurologist and accompanied by a significant other11630.9
      With an MS specialist nurse, unaccompanied by a significant other5113.6
      With an MS specialist nurse and accompanied by a significant other4411.3
      Never349.1
      “The following long-term prognosis can be measured by the tool. At the moment, which of these you most want to know?”   
      Whether / when you will need a stick16744.5
      Whether / when you will need a wheelchair18749.9
      Whether / when your MS will convert to the secondary progressive25969.1
      Life expectancy18148.3
      “Should we announce publicly the availability of the tool, such as on the web?”   
      1=Yes15641.6
      0=No8522.7
      2=Not sure13435.7
      • View popup
      Table 5

      - Relationship between the MS patient’s desire to be informed about tools for estimating long term prognosis and selected demographic variables.

      VariablesIf the development of this tool were to succeed, would you like to be informed of this tool’s availability during a clinic appointment?Chi SquareP-value
      No (n=54)Yes (n=321)
      Number (%)Number (%)
      Age     
      20 or less0 (0.0)14 (4.4)  
      20–3013 (24.1)115 (35.8)22.05<0.001
      31–4020 (37.0)142 (44.2)  
      41–5018 (33.3)34 (10.6)  
      51 and up3 (5.6)16 (5.0)  
      Gender   4.9340.020
      Male27 (50.0%)110 (34.3)  
      Female27 (50.0%)211 (65.7)  
      Education   2.8430.416
      Primary or Secondary10 (18.5)45 (14.0)  
      Occupational/diploma9(16.7)34 (10.6)  
      University or postgraduate34 (63.0)234 (72.9)  
      Other1 (1.9)8 (2.5)  
      • View popup
      Table 6

      - Comparison of the mean duration of diagnosis and duration of symptoms onset and the patient’s desire to be informed about tools for estimating long term prognosis.

      VariablesIf the development of this tool were to succeed, would you like to be informed of this tool’s availability during a clinic appointment?FP
      NoYes
      MeanSDMeanSD
      Duration since diagnosis (in years)11.316.868.136.330.8390.360
      Duration since the onset of symptoms12.117.129.196.451.3890.239
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    Do people with multiple sclerosis in Saudi Arabia want to know their prognosis? A cross-sectional nationwide study
    Yaser M. Al Malik, Awad S. Alharbi, Mohammed A. Alfurayh, Abdulaziz A. Aldalaan, Abdulazeez M. Alzailaie, Eid D. Alanazi, Ahmad A. Abulaban, Seraj O. Makkawi, Asma A. Alanazi
    Neurosciences Journal Apr 2025, 30 (2) 108-116; DOI: 10.17712/nsj.2025.2.20240094

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    Do people with multiple sclerosis in Saudi Arabia want to know their prognosis? A cross-sectional nationwide study
    Yaser M. Al Malik, Awad S. Alharbi, Mohammed A. Alfurayh, Abdulaziz A. Aldalaan, Abdulazeez M. Alzailaie, Eid D. Alanazi, Ahmad A. Abulaban, Seraj O. Makkawi, Asma A. Alanazi
    Neurosciences Journal Apr 2025, 30 (2) 108-116; DOI: 10.17712/nsj.2025.2.20240094
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