Healthcare professionals' experiences and perspectives of team-based interdisciplinary pain rehabilitation with immigrants requiring an interpreter. A qualitative study, Disability and Rehabilitation,

IntroductionAbout 20% of the adult population have chronic pain, often associated with psychological distress, sick leave and poor health. There are large variations in the clinical picture. A biopsychosocial approach is used in investigation and treatment. The concept of personalised medicine, that is, optimising medication types and dosages for individual patients based on biomarkers and other patient-related factors, has received increasing attention in different diseases but used less in chronic pain. This cooperative project from all Swedish University Hospitals will investigate whether there are changes in inflammation and metabolism patterns in saliva and blood in chronic pain patients and whether the changes correlate with clinical characteristics and rehabilitation outcomes.Methods and analysisPatients at multidisciplinary pain centres at University Hospitals in Sweden who have chosen to participate in the Swedish Quality Registry for Pain Rehabilitation and healthy sex-matched and age-matched individuals will be included in the study. Saliva and blood samples will be collected in addition to questionnaire data obtained from the register. From the samples, proteins, lipids, metabolites and micro-RNA will be analysed in relation to, for example, diagnosis, pain characteristics, psychological distress, body weight, pharmacological treatment and clinical rehabilitation results using advanced multivariate data analysis and bioinformatics.Ethics and disseminationThe study is approved by the Swedish Ethical Review Authority (Dnr 2021–04929) and will be conducted in accordance with the declaration of Helsinki.The results will be published in open access scientific journals and in popular scientific relevant journals such as those from patient organisations. Data will be also presented in scientific meetings, meeting with healthcare organisations and disseminated in different lecturers at the clinics and universities.

Aims To describe patients with persistent pain participating in multimodal rehabilitation with language interpreter (MMRI) with regard to demographic data, pain, anxiety, depression, fear of movement, health related quality of life before and after rehabilitation. Methods The university rehabilitation departments in Lund and Stockholm developed multimodal rehabilitation programmes for patients who cannot participate in ordinary programmes due to insufficient knowledge in Swedish. From 2014 to 2015, 50 patients participated in the MMRI. Data was collected at admission and discharge with instruments from the Swedish quality registry for pain rehabilitation. The assessments included health related quality of life (EQ5D), anxiety and depression (HADS), fear of movements (TSK), disability (PDI). Preliminary results Fifty patients participated in MMRI. Seventy-eight percent were women, and 88% were born outside Europe. Compared to patients participating in Swedish regular rehabilitation programmes (MMR), the level of education was low, 44% had finished high school (55% in MMR in Sweden) and 8% university (27% in MMR in Sweden). Also the distribution of pain differed; in MMRI 40% reported pain with varying localization compared to 33% in MMR. Both groups were frequent health care seekers, even though MMRl’s patients reported a higher frequency of visits than MMR regular patients; 94% of MMRl’s patients compared to 70% MMR patients were seeking physicians more than 4 times due to pain during the previous year. Both groups report very low health related quality of life. In the MMRI group, at admission, the EQ5Dindex was 0.088 (md) (MMR 0.157). This can be compared with 0.83, the value for the Swedish norm population. Conclusions Patients participating in MMRI, compared to patients participating in MMR, reported poorer health, higher rate of visit to physicians due to pain and less higher education than other, Swedish speaking pain patients attending to the country pain programmes.