The impact of COVID-19 on medical care and health service access in persons with multiple sclerosis - a cross-sectional study from the Australian MS Longitudinal Study

Objective This study aimed to determine the self-reported impacts of COVID-19 on healthcare disruption for persons with multiple sclerosis (MS) in Australia and the personal characteristics and service factors associated with disruption.

Design Cross-sectional study.

Setting Australia.

Participants We used 2020 data from the Australian MS Longitudinal Study survey (n=1484)

Outcome measures We used univariate and backward-stepwise regression to explore the disease-related and demographic predictors of: i) the self-perceived influence of COVID-19 on medical care; and ii) the impact of reduced access to health services on health. We also quantified the cumulative impact reduced access to each health service had on the cohort, incorporating the volume and severity of the impact on health.

Results Of the 1484 participants who provided data, 548 (36.9 %) participants reported the pandemic influenced their medical care. Participants who reported the pandemic influenced their medical care had a younger age, more comorbidities and more disability. 454 (30.6 %) participants reported that reduced access to health services impacted their health. Reduced access was most commonly reported for general practice (311, 21 %), neurology (246, 16.6 %) and physiotherapy (214, 14.4 %). Reduced access to physiotherapy had the greatest cumulative impact on health. The cumulative personal impact of reduced access across all health services was associated with several factors, including younger age, female sex and disability.

Conclusion One-third of Australians with MS experienced healthcare disruptions during the first year of the COVID-19 pandemic, with the reduced access to physiotherapy most significantly impacting health. The study underscores the importance of continuity of healthcare services during future crises and underscores the need for robust strategies such as hybrid healthcare models and telehealth frameworks to guard against risks to service delivery in the future.