{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T15:55:03Z","timestamp":1759334103495,"version":"build-2065373602"},"reference-count":38,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,8,28]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Multiple sclerosis (MS) is a common autoimmune illness that causes inflammation, demyelination and neurological damage. Symptom relief and immunotherapy are part of the treatment, but several healthcare barriers significantly influence outcomes and quality of life.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>This study aimed to assess different aspects among patients with MS, such as their knowledge of the disease, access to care, medications\u2019 beliefs and depression, and to evaluate any correlations between these variables and their impact on the presence of depression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A cross-sectional study was conducted from May 2024 to October 2024 at Al-Basheer Hospital, King Abdullah University Hospital (KAUH), Princess Basma Teaching Hospital and the Multiple Sclerosis Society of Amman. 200 participants were recruited after confirming consent. Data were collected through face-to-face interviews using validated instruments, covering sociodemographics, beliefs about medicines, knowledge about MS, access to care and levels of depression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>This study involved 200 patients with MS with a median age of 36 years, mostly women (70.5%), non-smokers (65%) and insured (77.5%). The majority had high education (58%) but low income (67%), with a mean duration of MS disease of 7.8 years after diagnosis. The majority (79.5%) were unaware of their MS type. Beliefs about medications varied, with 22% accepting, 48.5% ambivalent, 14.5% sceptical and 15% indifferent. Disease knowledge was high, with patients recognising MS as an immune, non-contagious and non-curable disease that affects women more than men. Despite good access to care, a percentage of patients needed to travel long distances for care. Depression affected 58% of participants, and it was influenced by access to care, concerning beliefs, income and education. Other variables such as gender, health insurance, the duration of the disease and the necessity of medications had no significant influence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In conclusion, patients with MS deal with various challenges, such as difficulties in accessing care, associated with psychological factors such as depression. Addressing these barriers by optimising patients' beliefs about medications, enhancing access to care and focusing on the level of knowledge of the disease is crucial for ensuring better and optimal treatment outcomes, as well as decreasing the risk of depression development.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-103299","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T09:16:23Z","timestamp":1759223783000},"page":"e103299","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the correlation between knowledge of multiple sclerosis, medication beliefs, access to care and depression in MS patients: a cross-sectional study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6214-3168","authenticated-orcid":false,"given":"Suhaib","family":"Muflih","sequence":"first","affiliation":[{"name":"Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doaa A","family":"Albtoush","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samah F","family":"Al-Shatnawi","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osama Y","family":"Alshogran","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salma Yasser","family":"Abu-Saleh","sequence":"additional","affiliation":[{"name":"Nutrition and Food Technology, Jordan University of Science and Technology, Irbid, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Alabbadi","sequence":"additional","affiliation":[{"name":"Biopharmaceutics and Clinical Pharmacy, The University of Jordan, Amman, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdel Qader","family":"Al Bawab","sequence":"additional","affiliation":[{"name":"Pharmacy Practice, Al-Zaytoonah University of Jordan, Amman, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"2025093002151545000_15.9.e103299.1","unstructured":"Lucchinetti C , Hohlfeld R . Multiple sclerosis 3, volume 34. In: E-Book: Blue books of neurology series. 35. 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The second pan-european multiple sclerosis multi-stakeholder colloquium: accelerating adoption of innovation for better care. agenda. 2015."},{"key":"2025093002151545000_15.9.e103299.11","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.46.4.907"},{"key":"2025093002151545000_15.9.e103299.12","doi-asserted-by":"publisher","DOI":"10.1177\/1352458506073482"},{"key":"2025093002151545000_15.9.e103299.13","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-009-0096-y"},{"key":"2025093002151545000_15.9.e103299.14","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.69.6.728"},{"key":"2025093002151545000_15.9.e103299.15","first-page":"360","article-title":"Urban\/Rural Differences in Access and Barriers to Health Carefor People with Multiple Sclerosis","volume":"29","author":"Buchanan","year":"2006","journal-title":"J Health Hum Serv Adm"},{"key":"2025093002151545000_15.9.e103299.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2013.12.011"},{"key":"2025093002151545000_15.9.e103299.17","doi-asserted-by":"crossref","first-page":"100484","DOI":"10.1016\/j.bbih.2022.100484","article-title":"Prevalence of depression and anxiety in the different clinical forms of multiple sclerosis and associations with disability: A systematic review and meta-analysis","volume":"24","author":"Peres","year":"2022","journal-title":"Brain, Behavior, & Immunity - Health"},{"key":"2025093002151545000_15.9.e103299.18","doi-asserted-by":"publisher","DOI":"10.1177\/070674370404900302"},{"key":"2025093002151545000_15.9.e103299.19","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/s40120-025-00728-8","article-title":"Understanding Depression in People Living with Multiple Sclerosis: A Narrative Review of Recent Literature","volume":"14","author":"Sullivan","year":"2025","journal-title":"Neurol Ther"},{"key":"2025093002151545000_15.9.e103299.20","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0266606","article-title":"Validation of the Arabic version of medication adherence report scale questionnaire and beliefs about medication -specific questionnaire: A factor analysis study","volume":"17","author":"Al-Qerem","year":"2022","journal-title":"PLoS ONE"},{"key":"2025093002151545000_15.9.e103299.21","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-022-27046-5","article-title":"Clinical and psychological characteristics associated with negative beliefs and concerns about treatment necessity in rheumatic diseases","volume":"12","author":"Tosato","year":"2022","journal-title":"Sci Rep"},{"key":"2025093002151545000_15.9.e103299.22","doi-asserted-by":"publisher","DOI":"10.1177\/1352458509352865"},{"key":"2025093002151545000_15.9.e103299.23","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1055\/s-0041-1734009","article-title":"Assessment of Multiple Sclerosis Awareness and Knowledge among the Community of Jeddah, Saudi Arabia","volume":"12","author":"Farran","year":"2021","journal-title":"J Neurosci Rural Pract"},{"key":"2025093002151545000_15.9.e103299.24","first-page":"184","article-title":"Psychometric properties of the arabic version of the obsessive compulsive beliefs questionnaire-44 in a student population","volume":"7","author":"Rahat","year":"2012","journal-title":"Iran J Psychiatry"},{"key":"2025093002151545000_15.9.e103299.25","unstructured":"Beck . 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