Multiple sclerosis (MS) is a chronic neurological disease that often begins in early adulthood and can progressively affect mobility, energy levels and daily functioning.

Under normal circumstances, many MS patients rely on disease-modifying therapies to reduce relapses and slow progression. In a collapsing healthcare system such as Lebanon’s, however, even basic healthcare can become inaccessible.

A  study led by Dr. Maya Zeineddine, clinical associate professor at the LAU School of Pharmacy, and co-authored by Dr. Mohamad El Dassouki, clinical assistant professor of neurology at the LAU Gilbert and Rose-Marie Chagoury School of Medicine, alongside researchers from institutions across Lebanon, examines the lived experiences of MS patients during the country’s economic crisis. The study centers on a simple but critical question: When access to medication is disrupted, what happens to people’s quality of life?

Published in the Quality of Life Research journal, the paper titled “Quality of life and access to treatment for patients with multiple sclerosis during economic crisis: the Lebanese experience,” connects quality-of-life outcomes directly to treatment access barriers during a national economic collapse.

“My goal in conducting the study was not only academic, but also humanitarian,” said Dr. Zeineddine. “I wanted to generate solid evidence to present to the Ministry of Public Health, as well as national, regional, and international MS societies, to advocate for better support, improved access to therapies and policy-level interventions to protect MS patients in Lebanon during times of crisis.”

As an MS specialist and clinician working closely with patients, Dr. Zeineddine had witnessed firsthand the consequences—treatment discontinuation, missed doses, therapy switches and a growing sense of uncertainty and fear—and “felt a strong professional and ethical responsibility to document this reality through objective scientific data.”

According to Dr. El Dassouki, approximately 60 percent of MS patients reportedly lost access to their treatments during the economic crisis, placing them at serious risk of disease progression and irreversible disability.

Between June and September 2022, the team surveyed 350 adults with confirmed MS across Lebanon. Participants answered questions about their background and health, completed an MS quality-of-life questionnaire (MusiQoL) and described what treatment access looked like during the crisis.

Overall, participants scored in a moderate quality-of-life range. However, approximately six in 10 patients reported a lack of access to their MS treatment during the crisis, mainly due to affordability and shortages of medication.

In response, patients adopted different coping strategies. Those with financial means or connections bought medication from abroad. Others switched to alternative therapies. A smaller group tried dose-skipping to avoid running out completely, and a large proportion of MS sufferers discontinued treatment altogether. Those who stopped treatment had the lowest quality-of-life scores, which drove home the human cost of interrupted care.

Furthermore, the study identified patterns associated with better outcomes. Younger individuals, those with higher levels of education, those who are employed, and those who are married were linked with higher quality-of-life scores. Not having physical disability also predicted better outcomes. In contrast, lack of insurance coverage and treatment discontinuation were associated with a worse quality of life.

Scores in the coping assessment were relatively high overall, which may reflect strong family support or psychological adaptation. However, participants’ relationships with friends scored notably low, indicative of a declining social life.  Dr. Zeineddine added that this could be explained by multiple factors such as financial strain, psychological burden and a shift toward family-centered coping.

In light of the study findings, Dr. Zeineddine stressed the need to ensure continuous access to MS therapies, develop crisis-resilient healthcare policies, strengthen insurance and reimbursement systems and implement data-driven advocacy. Structured, sustainable support mechanisms that guarantee continuity of care and protect the dignity and health of MS sufferers in the vulnerable minority were critical, added Dr. El Dassouki.

To browse more scholarly output by the LAU community, visit our open-access digital archive, the Lebanese American University Repository (LAUR)