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Mortality disparities among persons with intellectual disability are important to guide health-care practices. The objective was to evaluate mortality patterns of persons with intellectual disability in a nationwide study from 1976 to 2020. This study establishes a Danish nationwide cohort of persons with intellectual disability and age- and sex-matched reference cohort through linkage between several registers. We established a cohort of 79,114 persons with intellectual disability. Standardized mortality ratios were increased for persons with intellectual disability, most pronounced among younger persons and among females. Life expectancies were markedly lower; among persons with intellectual disability 63.6 years among females and 59.8 years among males in 2016-2020 compared to 82.4 and 78.7 years among females and males in the reference cohort. Life expectancies decreased with severity of intellectual disability. This study reports the establishment of a nationwide Danish cohort of persons with intellectual disability.

Abstract: Background: Therapeutic climbing (TC) has been increasingly implemented in the context of mental health care, with promising effects. While most evaluation studies focus on symptom reduction, the specific elements and mechanisms that make climbing effective compared to other therapeutic sports remain unclear. This study explores the subjective experiences of participants of a climbing therapy program in order to explore the underlying processes and the subjectively perceived effects. Method: The study took place at an inpatient rehabilitation facility in southern Germany, where a weekly group TC program was part of the treatment for individuals with mental disorders. Data from 265 participants with ICD-10 mental disorders collected between 2010 and 2022 was analyzed via questionnaires quantitatively assessing physical, psychological, and social improvements with rating items. Additionally open answers on subjectively relevant psychological experiences were analyzed using a qualitative content analysis. Results: Climbing therapy was generally perceived as relevant to their rehabilitation and rated as influential in terms of improving physical and psychological condition as well as sociability. The qualitative analysis identified five main categories being “Successful coping and positive mood”, “Challenge and coping strategies”, “Self-reflection and self-perception”, “Social experiences and belaying” and “Letting go of worries and being in the moment”. Conclusion: The results support previous findings on the benefits of TC and highlight its relevance as a therapeutic tool. Participants with mental disorders reported various positive experiences, emphasizing the unique demands, motivational aspects and social context of climbing. Further high-quality research is needed to compare climbing’s potential with other therapeutic sports across different target groups.

Abstract Aims Decision‐makers still predominantly focus on the perspective of non‐patient stakeholders, which may deviate from the unique perspective of heart failure (HF) patients. To enhance patient‐centred decision‐making, there is a need for more patient‐based evidence derived directly from the patients themselves. Hence, this study aimed to understand (i) HF patients' unmet medical needs and preferred treatment outcomes; (ii) patients' risk tolerance; and (iii) their information needs, uncertainties and satisfaction towards HF treatment. Methods This qualitative patient preference study consisted of a literature review with a systematic search strategy and semi‐structured interviews with HF patients, analysed using the framework method. During the interviews, patients were asked to rank a predefined list of disease and treatment‐related characteristics informed by the literature review and were able to spontaneously raise additional characteristics. Results The study included 14 Belgian HF patients (age range: 58–79, mean age: 72). (i) Regarding their unmet medical needs, HF patients reported that the most important unmet medical needs were shortness of breath and fatigue, as they negatively impact their quality of life (QoL) and independence. In the ranking exercise, patients prioritized improvements in QoL over improvements in life expectancy, whereby the following characteristics received the highest cumulative score: (1) independence, (2) shortness of breath, (3) impaired renal function, (4) survival, (5) fatigue, (6) risk of hospitalization and (7) communication with and between physicians. Patients most often spontaneously raise characteristics related to the general care process. Mechanism of action, route of administration, dose frequency and weight fluctuations scored among the least important characteristics. (ii) Regarding patients' risk tolerance towards HF treatment, some of the patients expressed zero tolerance for side effects, as they had not yet experienced any discomfort caused by the treatment or disease. (iii) Regarding their information needs, patients voiced their desire to receive practical and comprehensible advice orally from their physician because they highly value individualized treatment decision‐making. Patients also expressed uncertainties regarding whether the experienced effects were due to their treatment, disease, ageing or other comorbidities. Conclusions This study shows that, besides increasing life expectancy, HF patients prioritize improvements in symptoms and side effects reducing their QoL and independence, such as shortness of breath and fatigue. The patient‐relevant characteristics identified in this study, from the perspective of HF patients themselves, may be useful to inform clinical trial endpoint selection and guide downstream drug development, evaluation and clinical decision‐making towards addressing the unmet medical needs and treatment outcomes of importance to HF patients.

Abstract Background Eating disorders (EDs) constitute a considerable burden for individuals and society, but adequate and timely professional treatment is rare. Evidence-based Digital Mental Health Interventions (DMHIs) have the potential both to reduce this treatment gap and to increase treatment effectiveness. However, their integration into routine care is lacking. Understanding practitioners’ attitudes towards DMHIs for EDs is crucial for their effective use. Aims To investigate the consensus among German ED treatment experts on the relevance of different influencing factors for DMHI use in EDs. Methods This Delphi study consisted of two rounds and was conducted online with an initial sample of N = 24 ED experts (M age=41.96, SD age=9.92, n = 22 female). Prior to the Delphi rounds, semi-structured qualitative telephone interviews were performed to explore participants’ attitudes, experiences, and expectations towards DMHIs. In order to construct the Delphi survey, content analysis was applied to a subset of ten interviews. A total of 63 influencing factors were identified and grouped into three main categories: contextual conditions, design, and content of DMHIs. In both Delphi rounds, the interview participants were subsequently invited to rate each of the factors with regard to their importance on 10-point scales. Group percentages and individual ratings of the first round (n = 23) were presented in the second round (n = 21). Consensus was calculated for each item (defined as IQR ≤ 2). Results Importance ratings were high across items (M = 7.88, SD = 2.07, Mdn = 8). In the first round, 48% of the items reached consensus, with its most important (Mdn = 10) factors referring to data security, evidence base, technical requirements, usability, and specific DMHI content (psychoeducation, crisis intervention). In the second Delphi round, a consensus was reached on 73% of the items. No consensus was reached on 17 items. Conclusions The findings on practitioners’ attitudes and priorities have relevant implications for subsequent DMHI development, dissemination, and implementation strategies, indicating that the highest-rated factors should be highlighted in the process.

This follow-up study presents a design-based research (DBR) setting implemented over a three-year project called 'eKidZ - Teach Your Parents Well' which uses research-based learning and follows the four phases of DBR. In an iterative cycle, 20 teenagers aged 14-16 took on the role of researchers and investigated intergenerational learning and the multiplier effects of students participating in the Climate Change Education project 'k.i.d.Z.21 - Competent into the Future' on their parents, using the complete research process. Simultaneously, scientists implemented and tested the DBR setting to validate student research findings and to evaluate the quality of the educational setting. In this fully integrated DBR, using multiple methods (quantitative and qualitative), educational and scientific perspectives are brought together to evaluate students' findings and draw conclusions regarding their learning effects. These research results demonstrate that not only did students generate valid and reliable research, but - when changing perspectives - teenagers also contribute to the discussion about closing the gaps in science education and practice. By examining young people's research on Climate Change Education and recognising their contribution in scientific discourse, this paper offers a host of new insights. Highlights: Teenagers take on the role of researchers and perform reliable and valid research results on intergenerational learning and multiplier effects in Climate Change Education, by completing all phases of research-based learning. Design-based research is an effective method to combine science and education and thus delivering novel insights into science education and practice. High-quality Climate Change Education fosters constructive cooperation among all participants with inter - and intragenerational learning and multiplier effects. Constructivism, transdisciplinarity and research-based learning form the basis for effective design-based research and Climate Change Education.

BackgroundNew ways of reimbursement for high-cost, one-shot curative therapies such as advanced therapy medicinal products (ATMPs) are a growing area of interest to stakeholders in market access such as industry representatives, legislative and accounting experts, physicians, hospital managers, hospital pharmacists, patient representatives, policymakers, and sickness funds. Due to the complex nature of ATMPs, new payment models and reimbursement modalities are proposed yet not widely applied across Europe.ObjectivesThis study aimed to elicit opinions on and insights into the governance aspect of implementing outcome-based spread payments (OBSP) in Belgium for the reimbursement of innovative therapies. Stakeholders’ responsibilities and roles were analysed and proposed solutions or general beliefs were assessed to identify necessary or sufficient conditions to establish outcome-based spread payments.MethodsSemi-structured interviews (n = 33) were conducted with physicians (n = 2), hospital pharmacists (n = 4), hospital managers (n = 2), Belgian policymakers (n = 6), legislative experts (n = 2), accounting experts (n = 5), representatives of patients (n = 3), of industry (n = 5), and sickness funds (n = 4). The interviews took place between July 2020 and October 2020. The framework method analysis was performed using Nvivo software (version 20.4.1.851). Statements were allocated into six main topics: payment structure, spread payments, outcome-based agreements, governance, transparency, and regulation.ResultsInterviews revealed the necessary conditions that, fulfilled together, are seen to be sufficient for the successful implementation of OBSP, including consensus on pricing, payment logistics, robust data infrastructure and financing, clear agreement terms (duration, outcome parameters, payment triggers), long-term patient follow-up solutions, an external multi-stakeholder governance body, and transparency regarding agreement types.ConclusionDespite the interest, the effective implementation of OBSP falls behind due to a lack of consensus on how this new reimbursement method can be a sustainable solution. By stating the necessary conditions that, when fulfilled together, are deemed sufficient for successful OBSP implementation, this study provides a framework towards overcoming implementation barriers and realizing the potential of OBSP in transforming healthcare reimbursement practices.

Summary: Background: The Bari-SolidAct randomized controlled trial compared baricitinib with placebo in patients with severe COVID-19. A post hoc analysis revealed a higher incidence of serious adverse events (SAEs) among SARS-CoV-2-vaccinated participants who had received baricitinib. This sub-study aimed to investigate whether vaccination influences the safety profile of baricitinib in patients with severe COVID-19. Methods: Biobanked samples from 146 participants (55 vaccinated vs. 91 unvaccinated) were analysed longitudinally for inflammation markers, humoral responses, tissue viral loads, and plasma viral antigens on days 1, 3, and 8. High-dimensional analyses, including RNA sequencing and flow cytometry, were performed on available samples. Mediation analyses were used to assess relationships between SAEs, baseline-adjusted biomarkers, and treatment-vaccination status. Findings: Vaccinated participants were older, more frequently hospitalized, had more comorbidities, and exhibited higher nasopharyngeal viral loads. Baricitinib treatment did not affect antibody responses or viral clearance, but reduced markers of T-cell and monocyte activation compared to placebo (sCD25, sCD14, sCD163, sTIM-3). Age, baseline levels of plasma viral antigen, and several inflammatory markers, as well as IL-2, IL-6, Neopterin, CXCL16, sCD14, and suPAR on day 8 were associated with the occurrence of SAEs. However, mediation analyses of markers linked to SAEs, baricitinib treatment, or vaccination status did not reveal statistically significant interactions between vaccination status and SAEs. Interpretation: This sub-study did not identify any virus- or host-related biomarkers significantly associated with the interaction between SARS-CoV-2 vaccination status and the safety of baricitinib. However, caution should be exercised due to the moderate sample size. Funding: EU Horizon 2020 (grant number 101015736).

Objectives The objective of this study was to assess the completeness of registration of secondary preventive variables comparing on-site visits with telephone consultations during follow-up after myocardial infarction.Design This was an observational study based on the Swedish quality registry SWEDEHEART.Setting and outcome measures We analysed the proportion of missing values for major secondary preventive target data registered at the 2-month and 1-year follow-up visits, during 2006–2022 (n=101 199). χ2 tests were used to compare differences in data registration comparing on-site visits with telephone consultations. Patient characteristics and time trends in the proportion of missing values were also analysed.Results Baseline characteristics for patients with on-site visits and telephone consultations were similar. At the 2-month follow-up, the proportion of missing data registered at on-site visits compared with telephone consultations was systolic blood pressure 2.4% (n=1729) vs 28.0% (n=5462), low-density lipoprotein cholesterol 9.1% (n=6525) vs 32.6% (n=6360), weight 20.1% (n=14 343) vs 43.0% (n=8401) and haemoglobin A1c for patients with diabetes mellitus 39.4% (n=4594) vs 69.4% (n=2225), p for all

Introduction Reviews of economic evaluations of telehealth interventions found that the current evidence is inconsistent with standard guidelines for conducting economic evaluation. The reviews conclude that most economic evaluations of telehealth interventions are small-scale and short-term. The choice of time horizon in economic evaluation, in general, is an important part. When using longer time horizons, it often involves extrapolating costs and effects, where assumptions are taken. Different tools for extrapolating cost and effects in economic evaluations exist. However, there is a heterogeneity in the methods used, which can create different results. Therefore, this study aims to review the design and conduct of existing long-term economic evaluations of telehealth interventions using extrapolation methods. Furthermore, the aim is to map the methods used for extrapolation.Methods and analysis A scoping review is conducted to investigate the aim of this study. To identify relevant studies for inclusion in the scoping review, a systematic literature search will be conducted in the electronic databases: Embase (Elsevier), PubMed (National Library of Medicine), EconLit (ProQuest), Web of Science (Clarivate), NHS Economic Evaluation Database (NHS Centre for Reviews and Dissemination) and CINAHL (EBSCO Industries). A grey literature search will be conducted in Google Scholar. The search will be supplemented with studies identified by reviewing the references in the included studies and reviewing the citations of the included studies. The extracted data from the studies in the scoping review will be presented in relevant descriptive tables and summarising descriptions. The results will be reported in correspondence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guideline.Ethics and dissemination Hence, the methodology used is a scoping review of the existing literature; no ethical or safety considerations are identified for this study. The plan for dissemination includes a peer-reviewed publication and possible poster or oral presentations.

Generally, with increasing elevation, there is a corresponding decrease in annual mean air and soil temperatures, resulting in an overall decrease in ecosystem carbon dioxide (CO2) exchange. However, there is a lack of knowledge on the variations in CO2 exchange along elevation gradients in tundra ecosystems. Aiming to quantify CO2 exchange along elevation gradients in tundra ecosystems, we measured ecosystem CO2 exchange in the peak growing season along an elevation gradient (9–387 m above sea level, m.a.s.l) in an arctic heath tundra, West Greenland. We also performed an ex-situ incubation experiment based on soil samples collected along the elevation gradient, to assess the sensitivity of soil respiration to changes in temperature and soil moisture. There was no apparent temperature gradient along the elevation gradient, with the lowest air and soil temperatures at the second lowest elevation site (83 m). The lowest elevation site exhibited the highest net ecosystem exchange (NEE), ecosystem respiration (ER) and gross ecosystem production (GEP) rates, while the other three sites generally showed intercomparable CO2 exchange rates. Topography aspect-induced soil microclimate differences rather than the elevation were the primary drivers for the soil nutrient status and ecosystem CO2 exchange. The temperature sensitivity of soil respiration above 0 °C increased with elevation, while elevation did not regulate the temperature sensitivity below 0 °C or the moisture sensitivity. Soil total nitrogen, carbon, and ammonium contents were the controls of temperature sensitivity below 0 °C. Overall, our results emphasize the significance of considering elevation and microclimate when predicting the response of CO2 balance to climate change or upscaling to regional scales, particularly during the growing season. However, outside the growing season, other factors such as soil nutrient dynamics, play a more influential role in driving ecosystem CO2 fluxes. To accurately upscale or predict annual CO2 fluxes in arctic tundra regions, it is crucial to incorporate elevation-specific microclimate conditions into ecosystem models.

Background: Women with South Asian ethnicity have a higher risk of developing type 2 diabetes mellitus (T2DM) compared with white women of European descent, especially after gestational diabetes mellitus (GDM). Central obesity and adipose tissue dysfunction have been linked to their higher risk of T2DM, but the mechanisms are not known. We hypothesize that low-grade, persistent immune cell activation is involved in metabolic disturbances following GDM with different influence according to ethnicity. Methods: We measured plasma levels of T cell exhaustion marker soluble T cell immunoglobin mucin domain 3 (sTIM-3), sCD25, sCD27 and soluble lymphocyte activation gene (sLAG)-3 in 266 women of South Asian (n = 160) and white Nordic (n = 106) ethnic background with a history of GDM. Results: Baseline plasma concentration of sTIM-3 was higher in South Asian women compared to Nordic women (p

Objectives To re-evaluate cut-offs for disease activity states according to the Axial Spondyloarthritis Disease Activity Score (ASDAS), and study the impact of sex, age, calendar time, disease and symptom duration on ASDAS and ASDAS cut-offs in a large contemporary cohort.Methods Data from 2939 patients with axial spondyloarthritis (axSpA) starting their first tumour necrosis factor inhibitor in nine European registries were pooled and analysed. Receiver operating characteristic analyses were performed to identify cut-offs against external criteria. Six-month data including patient and physician global assessments, both ≤1 (0–10 integer scale), and Assessment of SpondyloArthritis International Society partial remission were used for separation of inactive disease (ID) from low disease activity (LDA), while patient and physician global ≤3 were applied as external criteria to separate LDA from high disease activity (HDA). Patient and physician global ≥6 were applied to separate HDA from very high disease activity in baseline data.Results The three ASDAS cut-offs identified to separate the four disease activity states in the overall patient population were 3.5. Cut-offs for ID and LDA in women were higher (

Dealing with students' conceptions is one of the central elements of student-oriented teaching. To be able to organize learning processes efficiently, it is necessary to look at the learners in a differentiated way and to approach their conceptions individually. The first necessary step is the individual diagnosis of each student's conceptions. This article presents a qualitative study (n = 8) that focused on the development of drawing assignments for the diagnosis of conceptions on the topic of plant nutrition. Based on the conceptual metaphor theory (CMT), features were identified that are beneficial for the diagnosis of the conceptions. To achieve this goal, it was crucial to reliably diagnose existing conceptions with valid assignments, which can also be carried out in schools. Research about task design and the proceeding diagnosis of conceptions in the light of the CMT has received little attention so far. This article, therefore, deals predominantly with the question about the design of assignments in the context of conceptual change. Based on this, guidelines were derived for the design of assignments for practical use in science education. This study represents the basis for developing a Moodle-based digital learning environment for working with students' conceptions on the topic of plant nutrition in schools.

IntroductionThe maintenance of intestinal homeostasis depends on a complex interaction between the immune system, intestinal epithelial barrier, and microbiota. Alteration in one of these components could lead to the development of inflammatory bowel diseases (IBD). Variants within the autophagy gene ATG16L1 have been implicated in susceptibility and severity of Crohn’s disease (CD). Individuals carrying the risk ATG16L1 T300A variant have higher caspase 3-dependent degradation of ATG16L1 resulting in impaired autophagy and increased cellular stress. ATG16L1-deficiency induces enhanced IL-1β secretion in dendritic cells in response to bacterial infection. Infection of ATG16L1-deficient mice with a persistent strain of murine norovirus renders these mice highly susceptible to dextran sulfate sodium colitis. Moreover, persistent norovirus infection leads to intestinal virus specific CD8+ T cells responses. Both Toll-like receptor 7 (TLR7), which recognizes single-stranded RNA viruses, and ATG16L1, which facilitates the delivery of viral nucleic acids to the autolysosome endosome, are required for anti-viral immune responses.Results and discussionHowever, the role of the enteric virome in IBD is still poorly understood. Here, we investigate the role of TLR7 and ATG16L1 in intestinal homeostasis and inflammation. At steady state, Tlr7-/- mice have a significant increase in large intestinal lamina propria (LP) granzyme B+ tissue-resident memory CD8+ T (TRM) cells compared to WT mice, reminiscent of persistent norovirus infection. Deletion of Atg16l1 in myeloid (Atg16l1ΔLyz2) or dendritic cells (Atg16l1ΔCd11c) leads to a similar increase of LP TRM. Furthermore, Tlr7-/- and Atg16l1ΔCd11c mice were more susceptible to dextran sulfate sodium colitis with an increase in disease activity index, histoscore, and increased secretion of IFN-γ and TNF-α. Treatment of Atg16l1ΔCd11c mice with the TLR7 agonist Imiquimod attenuated colonic inflammation in these mice. Our data demonstrate that ATG16L1-deficiency in myeloid and dendritic cells leads to an increase in LP TRM and consequently to increased susceptibility to colitis by impairing the recognition of enteric viruses by TLR7.ConclusionIn conclusion, the convergence of ATG16L1 and TLR7 signaling pathways plays an important role in the immune response to intestinal viruses. Our data suggest that activation of the TLR7 signaling pathway could be an attractive therapeutic target for CD patients with ATG16L1 risk variants.

Objectives Insufficient training and the absence of guidelines increase the risk of retraumatisation in torture survivors during surgical procedures. This study aims to develop guidelines to mitigate this risk and gather healthcare professionals’ experiences treating torture survivors and insights on the guideline’s feasibility and acceptability.Design The study was conducted in two phases. Phase ‘a’ involved developing guidelines based on reviews of torture survivors’ encounters in somatic care and potential retraumatisation triggers, as well as a qualitative study on survivors’ experiences during surgical interventions. The development process adhered to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) principles and the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument for methodological rigour. Phase ‘b’ involved focus groups and individual interviews with healthcare professionals to explore challenges in caring for torture survivors and to evaluate the guidelines.Setting The study, conducted from May to August 2023, involved participants from surgical departments in three hospitals in southern and southeastern Norway.Participants Twenty-one healthcare professionals, including surgeons, anaesthesiologists, nurses and a dentist, participated in the study. Both focus group interviews and individual interviews were conducted.Results Phase ‘a’: guidelines comprising six sections were developed: an introduction, general guidelines and four sections covering the preoperative, perioperative and postoperative surgical stages. Phase ‘b’: healthcare professionals struggled to understand torture’s complexities and identify survivors’ unique needs. They faced challenges using interpreters and assisting patients with strong reactions. While the guidelines were viewed as practical and useful for raising awareness, their length was questioned.Conclusions We provide recommendations for preventing retraumatisation in torture survivors undergoing surgical treatment. The guidelines may serve as a starting point for offering safe and individualised care to torture survivors. Teaching institutions and hospitals may incorporate the guidelines into healthcare professionals’ education.

Introduction: The COVID-19 pandemic has had a significant social and health impact. Given the high risk of contagion and the potential collapse of the healthcare system, strategies such as social isolation, the use of personal protective equipment, and an increased reliance on telemedicine were adopted. These measures altered the dynamics of end-of-life patient care. Methodology: This observational cross-sectional study explored the experiences of home care staff providing end-of-life care and the impact of the pandemic on the care process, as well as on their quality of life and emotional well-being. A survey incorporating the adapted Care Of the Dying Evaluation (iCODE) questionnaire was conducted, alongside an assessment of quality of life using question 30 of the EORTC QLQ, and emotional wellbeing using the PANAS scale. Results: The experiences of 131 deceased patients were characterized. Professionals reported adequate therapeutic efforts in managing pain, dyspnea, and delirium. Additionally, they noted that the pandemic impeded treatment in 24% of the patients. The average quality of life score for professionals was 6 points, with a predominantly positive affect reported. Conclusions: Healthcare professionals in home-based care programs observed that the pandemic affected the treatment of nearly a quarter of end-of-life patients. Nonetheless, they highlighted that satisfactory symptomatic care and control were maintained. Additionally, they reported an adequate quality of life.

Abstract Normal pressure hydrocephalus (NPH) leads to cognitive impairment (CI) as part of its triad of symptoms. Assessment of CI before and after a tap test can be used to inform diagnosis, differentiate NPH symptoms from alternative or concomitant causes of CI, and suggest the potential benefits of valve placement. The aims of this study are: to describe cognitive performance in patients with NPH diagnosis before and after a tap test, and to compare CI between patients with NPH meeting criteria for a dementia diagnosis (D +) and those without criteria for dementia (D−) at both baseline and after the tap-test. We performed a Before-and-after study evaluating clinical features and performance on cognitive tests (CERAD, ADAS-COG, SVF, PVF, ROCF and IFS). We included 76 NPH patients, with a median age of 81 years. 65 patients (87.8%) improved cognitive performance after tap test. ROCF (p = 0.018) and IFS (p

In this study we aim to explore healthcare and social work students’ experiences with VR simulation as a means of preparing for professional practice, and how these experiences contribute to their readiness for future professional roles. We collected data through focus group interviews with 28 students from bachelor’s programs in nursing, social education, social work, and occupational therapy, which we subsequently transcribed and analyzed using thematic analysis. Our findings highlight VR simulation’s potential as a valuable tool for professional practice training. VR simulation can be especially helpful for students who benefit less from ordinary clinical placements due to their need for more time and experience to become more confident in their professional role. By incorporating relevant aspects of the workplace and providing opportunities for repeated training, VR simulation can contribute to preparing students for the demands of professional practice.

The complexity of chronic pain requires interdisciplinary collaboration. Although this is recognisable in the framework for pain centres, few studies have investigated how interdisciplinary collaboration in pain centres is experienced by healthcare professionals, including the facilitators and barriers to interdisciplinary collaboration. The aim of the current study was therefore to investigate experiences of interdisciplinary collaboration in the treatment of patients with chronic pain among healthcare professionals in tertiary care pain centres.