Patients perspectives on an interprofessional care model in healthcare for patients with immune-mediated inflammatory diseases: A qualitative study

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Research indicates healthcare fragmentation due to mono-disciplinary approaches that address numerous comorbid conditions. While acknowledged as critical to IMIDs care, the joint coordination and management of somatic disorders, psychological disorders, and socioeconomic factors receive limited attention in current clinical practices. Research calls for more interprofessional approaches addressing IMIDs patients’ needs. Therefore, this study explored patients’ experiences participating in an interprofessional patient-centred complex IMIDs intervention to inform future development. Materials & Methods The study was based on semi-structured interviews with 11 participants. We used Thematic Analysis to analyse data. Results We identified three overarching themes: Bringing well-known actors into a new concept, Expanding interprofessional care, and Bridging interprofessional care. From the patients’ perspective, integrating expertise from well-known professionals and a broader spectrum of professionals was critical to addressing their complex IMIDs needs and avoiding fragmentation. Moreover, coordination administered by care coordinators was vital to their experiences of success. Conclusions This study presents a two-fold conceptualisation of interprofessional care to inform future IMIDs intervention development. Our results underscore the importance of individualising and tailoring treatment through patient-centred care to help patients improve their IMIDs and self-management skills. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/14-686", "name": "Patients perspectives on an interprofessional care model in healthcare..." } } ] } Home Browse Patients perspectives on an interprofessional care model in healthcare... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Møller L, Nielsen BK, Rasmussen GS et al. Patients perspectives on an interprofessional care model in healthcare for patients with immune-mediated inflammatory diseases: A qualitative study [version 1; peer review: awaiting peer review] . F1000Research 2025, 14 :686 ( https://doi.org/10.12688/f1000research.165824.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Patients perspectives on an interprofessional care model in healthcare for patients with immune-mediated inflammatory diseases: A qualitative study [version 1; peer review: awaiting peer review] Louise Møller https://orcid.org/0009-0006-3046-3390 1 , Berit Kjærside Nielsen 2 , Gitte Susanne Rasmussen 3 , Kasper Fjellhaugen Hjuler 4 , Lars Iversen 5 , Morten Deleuran Terkildsen 2 Louise Møller https://orcid.org/0009-0006-3046-3390 1 , Berit Kjærside Nielsen 2 , [...] Gitte Susanne Rasmussen 3 , Kasper Fjellhaugen Hjuler 4 , Lars Iversen 5 , Morten Deleuran Terkildsen 2 PUBLISHED 11 Jul 2025 Author details Author details 1 Department of Dermatology, National Center for Autoimmune Diseases, Aarhus, 8200, Denmark 2 DEFACTUM Public Health Research, DEFACTUM, Central Denmark Region, 8000, Denmark 3 Department of Dermatology, Aarhus University Hospital, Aarhus, 8200, Denmark 4 Department of Dermatology, Aalborg University Hospital, Aalborg, 9000, Denmark 5 Department of Clinical Medicine, Faculty of Health, Aarhus, 8000, Denmark Louise Møller Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Project Administration, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Berit Kjærside Nielsen Roles: Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Gitte Susanne Rasmussen Roles: Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Kasper Fjellhaugen Hjuler Roles: Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Lars Iversen Roles: Writing – Original Draft Preparation, Writing – Review & Editing Morten Deleuran Terkildsen Roles: Conceptualization, Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW REVIEWER STATUS AWAITING PEER REVIEW This article is included in the Health Services gateway. Abstract Background Managing immune-mediated inflammatory diseases(IMIDs) is complex for patients and healthcare professionals. Research indicates healthcare fragmentation due to mono-disciplinary approaches that address numerous comorbid conditions. While acknowledged as critical to IMIDs care, the joint coordination and management of somatic disorders, psychological disorders, and socioeconomic factors receive limited attention in current clinical practices. Research calls for more interprofessional approaches addressing IMIDs patients’ needs. Therefore, this study explored patients’ experiences participating in an interprofessional patient-centred complex IMIDs intervention to inform future development. Materials & Methods The study was based on semi-structured interviews with 11 participants. We used Thematic Analysis to analyse data. Results We identified three overarching themes: Bringing well-known actors into a new concept, Expanding interprofessional care, and Bridging interprofessional care. From the patients’ perspective, integrating expertise from well-known professionals and a broader spectrum of professionals was critical to addressing their complex IMIDs needs and avoiding fragmentation. Moreover, coordination administered by care coordinators was vital to their experiences of success. Conclusions This study presents a two-fold conceptualisation of interprofessional care to inform future IMIDs intervention development. Our results underscore the importance of individualising and tailoring treatment through patient-centred care to help patients improve their IMIDs and self-management skills. READ ALL READ LESS Keywords Health care, Immune-mediated-inflammatory-diseases, fragmentation, interprofessional care, self-management, patient-centred care Corresponding Author(s) Louise Møller ( [email protected] ) Close Corresponding author: Louise Møller Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Møller L et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Møller L, Nielsen BK, Rasmussen GS et al. Patients perspectives on an interprofessional care model in healthcare for patients with immune-mediated inflammatory diseases: A qualitative study [version 1; peer review: awaiting peer review] . F1000Research 2025, 14 :686 ( https://doi.org/10.12688/f1000research.165824.1 ) First published: 11 Jul 2025, 14 :686 ( https://doi.org/10.12688/f1000research.165824.1 ) Latest published: 11 Jul 2025, 14 :686 ( https://doi.org/10.12688/f1000research.165824.1 ) Introduction Psoriasis, Hidradenitis Suppurativa (HS), psoriatic arthritis (PsA), axial spondyloarthritis (axSpA), Crohn’s disease (CD), and Ulcerative Colitis (UC) are defined as immune-mediated inflammatory diseases (IMIDs). They are generally defined as common chronic conditions and affect approximately 10 % of the Western population. 1 As IMIDs often share the same overlapping immunopathogenic mechanisms, they are associated with several common comorbidities that require stringent simultaneous attention to address the full spectrum of the diseases. The complexity of managing IMIDs is well-known in the health care system, but still, several barriers exist in the delivery of high quality for patients dealing with multiple IMIDs. These challenges concern a limited awareness of other IMIDs among patients and healthcare professionals (HCPs). An absence of regular screening for additional IMIDs and keeping specialists isolated results in delays in referrals from one specialist to another and a lack of consensus regarding treatment goals and outcome measures among HCPs. 2 Comorbidities are often unrecognised, underdiagnosed, and undertreated. Moreover, IMIDs trajectories often suffer from discontinuity in physician care and inadequate communication among different HCPs. 2 A lack of patient-centred care where uncertainties related to work, insufficient knowledge and understanding of the disease within the social system, and adverse consequences due to delays in the diagnostic process are challenges that IMIDs patients deal with in the patient journey. 3 , 4 A rising research field is therefore increasingly focusing on developing and documenting interprofessional care interventions to ameliorate such challenges. 5 , 6 Background IMIDs lead to signs and symptoms in various organ systems, including the skin, joints and gastrointestinal system, and general symptoms such as fatigue, affecting and challenging quality of life. 6 Patients with IMIDs deal with various challenges in their daily lives, including psychological disorders and socioeconomic issues. Psychological disorders like depression and anxiety have been reported as typical for all diseases. A French cohort of 1185 IBD (inflammatory bowel disease) patients showed that half of the patients reported poor quality of life, severe fatigue, and/or depression. Approximately one-third of patients reported anxiety. 7 Additionally, studies demonstrate that psoriasis and HS patients face reduced health-related quality of life, heightened emotional issues like depression and anxiety, and endure stigmatisation, shame, and embarrassment. 8 , 9 These challenges may lead to social avoidance, exacerbating anxiety and depressive symptoms. 9 Instances of depression and anxiety have also been reported as prevalent in studies among PsA and AxSpa patients and explained as the results of concurrent experiences of pain and living with a functional disability. 10 , 11 Socioeconomic factors have also been described as posing a challenge to IMIDs patients as physical limitations and emotional distress often affect their job performance, leading to loss of productivity at work and a higher rate of absence compared to healthy individuals, in turn resulting in substantial indirect expenses and a strained economy. 7 , 10 , 12 , 13 Cardiometabolic diseases are common in all the prior-mentioned IMIDs, as chronic systemic low-grade inflammation facilitates inflammatory activity in the vascular wall, which is implicated in the development of premature atherosclerosis, resulting in an increased risk of cardiovascular disease. 14 – 18 A focus on preventing obesity, type II diabetes, hypertension, and dyslipidemia is essential to prevent the development of metabolic syndromes that increase the expansion of atherosclerosis for all the mentioned IMIDs. 14 , 16 , 18 – 20 Therefore, several studies advocate for approaches that include a team of professionals focusing on person-centred care when the goal is to deliver high-quality care. 2 , 9 , 10 , 21 , 22 The concept of patient-centred care has seen various interpretations. However, these interpretations generally agree that patient-centred care involves trajectories in which patients are stimulated to participate actively in their health and treatment. The goal is to improve patient experiences and advance more holistic care (see, e.g., Refs. 27 , 28 ). Moreover, the concept entails respect and dignity for the entire person and its needs while promoting self-management. 23 , 24 We follow Nikiphorou et al.’s conception of self-management as a process allowing patients to take an active role in the conditions related to their diseases and take part in the decisions during the patient journey. 25 Self-management involves both patients and healthcare professionals. From the patient’s perspective, it entails actively managing life focusing on health and well-being. Developing self-management skills encourages patients to collaborate with healthcare professionals, enabling them to access the correct information, participate in care decisions, and adapt throughout their patient journey. 24 , 25 For healthcare professionals, self-management support is an aiding process that helps patients learn to make daily decisions, enhancing health-related behaviours and outcomes. This process includes three sets of tasks: medical management of the condition (condition management), carrying out normal relationships and activities (role management), and managing the emotional impact of disease (emotional management). 26 Most studies in the field refer to multidisciplinary approaches, bringing together doctors from various specialised clinics to optimise medical treatment. These approaches operate without a cadenced and organised collaboration, including meeting structures where symptoms are discussed interprofessional and treatment trajectories departing in patient-centred care amenable to the patient’s needs are coordinated among the professionals. 1 , 2 , 21 , 27 , 28 Thus, the recommendation is to prioritise interprofessional team interventions, emphasising collaborative practices involving responsibility, coordination, communication, trust, and respect in managing patients with chronic diseases for enhanced and suitable patient care. 5 , 29 However, existing studies are scarce. Urgent calls are made for more empirical research on interprofessional, patient-centred approaches for IMIDs, aiming to document their implications for IMIDs patients. This study is part of a Danish interprofessional intervention study tailored to patients with IMIDs, where patients are offered an interprofessional treatment and care plan and the opportunity to improve self-management skills/competence in everyday life with IMIDs. 6 A deeper understanding of the different parts of the intervention can contribute to the future development of IMIDs interventions. Therefore, the aim was to explore patients’ experience of participation in the intervention. Materials and Methods The National Centre of Autoimmune Diseases (NCAS) was established in 2019 and financed by the Danish Ministry of Health in collaboration with patient organisations. As a substudy to the parent randomised trial (ClinicalTrials.gov NCT04200690; registered 16 December 2019; study start 14 January 2020; primary completion 31 January 2023; final completion 31 January 2024), 6 the participants randomised to the interprofessional clinical-care model were invited to take part in semi-structured interviews after completing six months of interprofessional treatment. Setting The intervention examined in this study the collaborative approach adopted by an interdisciplinary team. This approach in the NCAS intervention is characterized by a holistic and interdisciplinary organization of diagnosis, management, and care for patients suffering from complex IMIDs. The team comprises dermatologists, gastroenterologists, rheumatologists, nurses, psychologists, dietitians, social workers, and administrative staff, with physiotherapists contributing as required. Treatment plans are tailored to each patient, considering clinical data, biomarkers, phenotypic information, and psychosocial factors. Consultations are conducted in a collaborative manner, ensuring seamless coordination across different specialties. Medical management adheres to established local, national, and international guidelines. Therefore, the focus of the intervention is on the integrated and coordinated care model rather than on specific pharmaceutical interventions. Developing an interprofessional combined clinic provided the opportunity to focus on a cross-disciplinary approach to optimise treatment plans for all diseases in the same clinic with a broader aspect on quality of life, mental health, dietary advice, socioeconomic factors, and self-management support. In the consultations, the nurses used the Goal-based-shared-decision-making model 30 in collaboration with the patients when making the psycho-social anamnesis at the first visit. The nurse supported patients in defining up to three goals to promote a higher level of self-management. These goals facilitated who should be a part of the patient’s interprofessional team to manage their daily life with IMIDs. Participants The participants referred to NCAS had at least two IMIDs, and most of them had several comorbidities ( Table 1 ). Given that IMIDs are chronic conditions, their comorbidities are associated conditions that need to be treated either in primary care or in another specialised clinic. Depending on the number of diseases, this leaves the participant with a daily life characterised by many contacts with the healthcare system, which, in addition to the burden of symptoms, also hinders their functional and fundamental abilities. Table 1. Patient characteristics. Patient characteristics Mean Std. Deviation Age 41 14,69013 Female 40,3750 16,6 Male 42,6667 10,6 N Female (72, 7%) Male (27, 3%) Diagnosis Psoriasis 54.5 57.1 50.0 Hidrosadenitis Suppurativa 18.2 28.6 0.0 Psoriatic arthritis 36.4 28.6 33.3 Axial Spondylatis 42.9 28.6 33.3 IBD ass. Arthritis 18.2 28.6 0.0 Crohn’s disease 18.2 28.6 0.0 Colitis ulcerosa 36.4 42.9 33.3 Comorbidities Obesity 72.7 71.4 66.6 Hypertension 9.1 0.0 33.3 Dyslipidimia 18.2 28.6 33.3 Occupational status (%) Full time 27.3 42.9 0.0 Part time 36.4 42.9 33.3 Sick leave 18.2 28.6 0.0 Other 9.1 14.3 0.0 Cohabiting (%) 90.9 85.7 100.0 Interprofessional intervention by (%) a Three allied health care professionals 54.5 42.9 100.0 Two allied health care professionals 27.3 42.9 0.0 One allied health care professional 18.2 28.6 0.0 a Participants were offered referral to a phycologist, a dietician and/or a social worker to be a part of their interdisciplinary team. In the period from 2020-2021, we included participants in the interviews. Data collection Data were collected by a semi-structured interview with a duration from 30 min. to 60 min. The interview guide included questions about their daily living with IMIDs and questions concerning their experiences in their patient journey with IMIDs. The interview guide was developed stepwise. The first two questions were: “How do you experience living with one or more autoimmune diseases?” “Do you perceive these diseases as limiting your life and daily activities?” The interviews were kept broad with open questions about life with a chronic condition. That gave us an insight into how complex managing life can be when living with more than one disease. After the first two interviews, we revised the interview guide to include questions concerning aspects of living with IMIDs: quality of life, work life, and social life. Moreover, we added questions to elicit the experiences of patients having gone through a trajectory at NCAS. Data analysis The interviews were recorded and transcribed by a working group consisting of a sociologist/social worker and two nurses. We used the qualitative software program NVivo TM 31 to organise and manage the data. Inspired by Braun and Clarke, 32 we followed their six-step method to analyse data with a reflective thematic analysis approach. The first and last authors conducted the data analysis supported by discussions with the research group. We started with multiple readings to familiarise ourselves with the data. During this process, we divided the transcribed interviews according to interesting features. Having discussed these features with the group, we then developed codes (“The burden of illness & social life”, “Clinical experiences”, and “Challenges in the intervention”), each containing several subcodes. Last and first authors conducted an independent test coding to ensure consistency in the understanding of the codes and the material. We then coded the remaining material. Having arranged data into meaningful groups, we sorted our codes into potential themes. Next, we reviewed and refined our proposed themes, carefully checking if our themes worked in terms of the coded extracts and the entire data set. At this stage we found overlaps between some of our themes, so these were collapsed. Finally, we moved on to defining and naming the themes. Here, we focused on identifying the core of each theme, naming the themes and sub‐themes accordingly. We identified three overarching themes: Bringing well-known actors into a new concept, Expanding interprofessional care and Bridging interprofessional care, and several subthemes. Finally, we selected concise samples that captured the core of themes and subthemes. Results A common finding across all interviews and within the themes was that participants consistently highlighted the intervention’s ability to address what they perceived as a disease condition that profoundly impacted multiple aspects of their lives. In the interviews, the intervention was described positively as representing much-sought interprofessionality and as recognising the whole human being. As one participant vividly said during an interview: “It has been really nice that I am not just seen as a disease but as a whole person. They also ask about quality of life. I think that has been really helpful. (…) When I’m in the gastroenterology department, I am just seen as Crohn’s disease, and when I’m in the rheumatology department, I am seen as arthritis. But here, I have all the diseases, but I am also a person behind them, and I am quite happy about that”. In the analysis, we found that participants held different perspectives on how interprofessionality was influenced by the intervention. Bringing well-known actors into a new concept Participants described the intervention as a novel space where the familiar healthcare system was restructured. Specialists were assembled in the same clinic within an interprofessional team, eliminating the need for participants to navigate the healthcare system to meet individual specialists. For example, one participant explained how bringing doctors together was essential because it provided continuity and safety, not being the person responsible for passing on vital information: “I just walk in, and a dermatologist and a rheumatologist are waiting for me, and they examine me. It’s been so stress-free, getting everything taken care of. I don’t have to worry about going to different places and wondering if they’ve communicated with each other. They know what they’ve discussed, how I looked when I started, and how I look now (…) this is 100% easier, as I don’t have to say ‘The Department of Rheumatology’ said this and that”. Another participant emphasised the essential of the shared exchange of information between medical professionals regarding treatment possibilities: “I like it when a doctor asks for advice from other doctors because it brings additional perspectives and angles that may not have been seen before. I think that’s cool”. Several participants shared experiences from their past healthcare journeys, illustrating how the new interprofessional collaboration, with multiple specialised doctors present in their consultations, contrasted with prior experiences of being confined in a silo system. A system, though highly specialised, that could only address one specific focus at a time. Most participants noted that previous trajectories did not understand the association between diseases, resulting in fragmented treatment experiences. One participant uttered: “Previously, I have received treatments for gastrointestinal diseases, and later in the rheumatology department, which was fine, but I didn’t feel like they had the full overview (…), and I didn’t fit into either of the two departments”. One participant used a car service metaphor to compare the differences between the new and the traditional care. She stressed that interprofessional consultations ensured a shared understanding of her disease and relieved the burden of remembering and presenting intricate medical details when transitioning between departments, a task she had struggled with previously: “It’s about not being divided into fragments. It feels like going to a mechanic servicing a rear bumper in one garage and a front wheel in another. There’s no coherence (…) Here, it’s just easy because everything is in one place, and you don’t have to go so many times, and there’s not so much you have to remember yourself”. Expanding interprofessional care In interviews, participants highlighted specialised support from psychologists, social workers, and dieticians in the intervention, addressing everyday life challenges impacted by health conditions and focusing on the broad issues associated with IMIDs that permeated participants’ whole lives. Work-life-balance For many, a job was considered an integral part of a normal life. However, the impact of their disease often added pressure to maintaining this normalcy, necessitating constant management. For instance, one participant with Crohn’s disease described the stress on his work routine, needing to balance physical work and travel while always being in proximity to a toilet due to sudden needs: “It has affected my work life a lot(…) I have a physical job. It can be long days when you’re away from the restroom or have to wake up early. You have to wake up early and drive three hours, so you can’t find that routine you could use when you have a disease(…) So it has been difficult to find the balance”. Participants tried to endure and adapt to challenging conditions, viewing having a job as fundamental financially and existentially. In interviews, they emphasised the assistance of a social worker in the intervention, aiding their understanding of legislative options, such as the possibility of a “§56 deal,” enabling them to work in conditions accommodating their disease (i.e., reduced work hours). One participant described the help she had received like this: “I’m a completely different person, you could say. And that’s why, among other reasons, I’m fighting to work 37 hours a week because I want to and I enjoy working. So it gives me quality of life (…) And being helped by the social worker to receive a §56 has been a huge win for me. I got that in this course of treatment”. To the participants, having a social worker supported them by providing help, guidance, and direction regarding their position in the labour market, something perceived as a crucial component of their whole lives. Social and existential management of disease Among participants, the significance of being introduced to counselling by a psychologist was highlighted, as it assisted them in addressing the numerous social and existential challenges accompanying life with a disease. For instance, one participant shared that the psychologist’s support helped her navigate the pervasive impact of the disease on every aspect of her being, alleviating feelings of being lost and in darkness: “She has helped me a lot when everything becomes completely black. What tools I can use to sort of get out of that darkness”. Several participants described their trajectory with the psychologist as something to overcome due to the perceived vulnerability and stigma associated with seeking psychological support. (“ It’s a taboo subject ” (patient interview)). Overcoming this hurdle proved significant as the psychologist taught participants to discuss their disease openly with friends, relatives, and acquaintances. Participants highlighted their family’s struggles with the disease. One participant shared difficulty accepting feelings of disempowerment, particularly regarding her children. Sessions with the psychologist in the intervention lead to feelings of self-management and of being capable of being a better parent: “I didn’t think that (speaking to a psychologist) was what I would benefit the most from. (…) But having those conversations with a psychologist, I must say, has been a bit of a game-changer for me”. Most participants emphasised the importance of the psychologist’s proper understanding of the disease to facilitate discussions and improve their conditions during interprofessional conferences. One participant compared the psychologist he was seeing now to the one he had seen in the intervention: “My psychologist that I’m talking to now, she can’t really… I think that the one down here is maybe more specialised in how it is to have a disease. (…) I think talking to someone about these things is important because psoriasis flares up if you’re stressed or if something else affects you”. Participants engaged in group sessions with a psychologist, but experiences varied. Some found group discussions crucial for expressing and sharing individual disease problems and fostering mental well-being through mutual support. However, others perceived the group format as conflicting with their privacy, leading them to leave the sessions. Nutrition: the role in overall well-being with illness Several participants underlined how seeing a dietitian helped them understand and cope with their disease, its dietary causality, and the influence this could have on life outside the hospital. Patients found collaboration with the dietician provided new strategies for managing elevated cholesterol and early-stage type 2 diabetes. Most reported gaining insights that lead to improved dietary habits, contributing to increased energy, stable blood sugar levels, and overall health. They also appreciated the guidance on weight loss to prevent comorbidities and symptom exacerbation. A woman with psoriasis and psoriatic arthritis explained how she had learned about the complexity of balancing between low energy and acknowledging the effect of proper nutrition: “…I am definitely overweight, and there is a tendency for that when you have this illness. So, how do you provide your body with the nutrients it needs when you have such low energy? I just never imagined that there was a place where all of these things were acknowledged and that played a role in improving me overall wellness concerning illness”. Several participants faced challenges adhering to diet plans due to the high energy and mental capacity demands, which were often lacking when dealing with chronic inflammatory diseases. Despite trying various diets, participants frequently reverted to previous habits after a short period. Participants noted that the dietician in the intervention simplified diets and emphasised adapting lifestyle habits, resulting in significant positive changes for them. One participant said: “Well, when I talked to the dietician about blood sugar, I thought, am I now going to have diabetes and all that, …but then I had it measured again after five weeks, and it was normal”. During treatment with the dietician, participants found that proper nutrition provided increased energy, aiding in managing their condition. They learned preventive measures and overall wellness strategies, enhancing their ability to manage comorbidities. Bridging interprofessional care Bringing together the interprofessional team of well-established and new professions and keeping it organised was seen by the participants as salient for a patient journey in which they felt the centre of the joint professional attention. Living with IMIDs was experienced as complex for the patient journey due to several diseases with different symptoms, different flare-ups, and remission and, therefore, different needs for medical optimisation. A participant described the value of a consistent interprofessional team: “But I also think that it’s important that there is a team that works well together instead of having a new person every single time. It’s important to have fresh perspectives, but I think it’s difficult for the person to read on a computer screen what matters to this individual. Because they don’t know the person personally, and that’s what they did in the (NCAS) team”. Participants identified effective professional coordination as crucial for the success of the intervention components. The participants further underlined how the contact nurse acting as a care coordinator was vital in achieving this goal. Several participants described her as a node in the intervention that, through her close dialogues with both the patients and professionals, helped to keep information from the different professionals together and aligned with the needs of the patients. One participant uttered during an interview: “Because the contact nurse was someone who could gather my entire situation. Even though I needed a dietician and psychologist, my contact nurse was someone who could coordinate all the different things that could help me and who understood me as a person (…) one person, and that was really good”. Other participants highlighted the care coordinator as essential, serving as an additional set of ears to ask crucial questions on behalf of patients. It also relieved participants from the burden of remembering vital information from consultations to guide their actions. A participant uttered. “It has also been a huge help on my home front. I didn’t have to have my partner with me because now I suddenly had (name of nurse) who could help. It means a lot, really a lot. Also for the safety and security of oneself”. This help from the nurse resulted in experiences of reduced pressure and, for some, a lighter burden on relatives involved in their treatment. Participants emphasised the significance of a close relationship with a care coordinator, particularly a contact nurse, fostering companionship through sharing intimate details. The nurse served as an ambassador, bridging gaps and actively working for participants and their families. This companionship empowered participants to openly discuss the burdens of their everyday lives with chronic inflammatory diseases. A participant described the trust and security in the relation with the contact nurse this way: “Yes, actually, the sense of security means a lot. It makes you look forward to going there instead of thinking, “Oh, what do I have to deal with now?” Do they understand my problem and why I am here? They may understand the illness, but do they understand me? And that’s exactly what I haven’t felt here”. A close relationship with the nurse seemed critical to having confidence and building trust in the intervention. Participants highlighted the care coordinator as a decisive factor in participating in specific intervention components. For instance, a participant expressed that without a connection to the care coordinator, she would not have opted for referrals to a psychologist and a social worker: “If we two had been sitting here and you had been my nurse and recommended me to go down there, and it was the first time I saw you, I wouldn’t have done it, I wouldn’t have. So it takes more than that? It takes a certain connection and level of trust for one to dare to do it”. Therefore, the care coordinator was seen as having a unique role and necessary role to bridge the expanded interprofessional approaches in the intervention. Discussion This study highlighted the importance of implementing an expanded interprofessional care approach for patients with IMIDs. The approach in the study involved collaboration and coordination among various healthcare professionals, including rheumatologists, gastroenterologists, dermatologists, nurses, and new and allied health and social non-health professionals, such as dieticians, psychologists, and social workers. By integrating expertise from multiple professionals, this model of care was perceived by patients as ameliorating their diverse and complex needs. The expanded interprofessional care model enabled healthcare providers to develop patient-centred care tailored to patients’ needs. By considering interprofessional perspectives and expertise, professionals could optimise treatment strategies. Our study also showed that the participant’s descriptions emphasised the need to involve patients actively in healthcare decisions. By adopting an expanded interprofessional care approach, participants had access to a broader range of professionals who could provide comprehensive self-management and shared decision-making, promoting perceptions of improved satisfaction and positive experiences of achieving increased health and well-being. IMIDs are characterized by abnormal immune responses and chronic inflammation, resulting in multiple comorbidities. 1 , 2 , 6 Research indicates that effective IMID treatment requires interprofessional collaboration, aligning goals, and delivering comprehensive care that addresses complex patient needs across disciplines. 2 , 6 However, such treatment pathways for IMID patients are scarce. Current research indicates widespread healthcare fragmentation due to mono-disciplinary approaches that inadequately address multiple comorbid conditions. Existing healthcare systems often burden healthcare providers and patients with the responsibility of communication between clinics for quality care. 2 , 3 Gianfredi et al. found that 30% of psoriasis and psoriatic arthritis patients required treatment adjustments, with 60% needing diagnostic re-evaluation due to fragmented approaches. Our study aligns with these findings, as patients encountered a fragmented healthcare system that addressed their conditions individually, neglecting their interconnectedness. This condition made patients feel responsible for remembering treatment details and coordinating their care, highlighting the lack of practical coordination among medical specialties. Studies recommend interprofessional interventions to mitigate fragmentation. 10 , 18 , 30 These unite specialists versed in IMID’s constituent diseases, promoting treatment pathways that match the condition’s interconnected nature. Collaboration fosters better communication among healthcare specialties, potentially improving diagnosis, medication, patient and physician satisfaction, and patient empowerment. 18 Our study showcased such practical interprofessional collaboration, 18 , 22 , 29 breaking down silos among specialised health professionals treating individual diseases within IMIDs and bridging their work to enhance treatment outcomes and ensure the quality of health care. 33 , 34 Our study emphasises the benefits of bringing well-known actors in recognised medical specialties closer together to enhance collaboration. Additionally, it underscores that expanding interprofessional care by introducing a variety of professions alongside familiar ones in care planning can address challenges posed by chronic conditions like IMID in areas such as work, family, social life, and lifestyle for patients. IMID patients often find managing everyday practices like housework, grocery shopping, and work challenging. They could benefit from interprofessional interventions addressing psychological, social, sexual, and work-related aspects of their daily lives. 1 , 9 , 10 , 13 , 16 , 35 – 38 Our study aligns with these calls, demonstrating that participants benefit from including a psychologist to address specific psychological needs related to living with IMIDs. Participants emphasised the importance of a psychologist with insight into the disease burden, guiding patients in managing social and existential problems arising from the disease. However, the addition of a psychologist should include strategies for ameliorating the feelings of vulnerability and stigma in needing to talk with a psychologist that may follow for some patients. We found that a dietician aided patients by providing insight into the diseases, dietary causality, and potential comorbidities associated with living with IMIDs. Participants noted that the guidance enabled strategies to manage their disease, with proper nutrition contributing to increased energy and overall wellness. Data highlights the vital role of social workers (non-medical specialists) in guiding individuals with IMIDs and chronic diseases to manage their lives and sustain an effective work-life. Some participants associated their identity closely with their profession and felt that work limitations negatively impacted their quality of life. Literature on work and identity confirms work’s essential role in people’s lives, providing economic security, independence, mental health benefits, and social relations that shape self-worth and identity. 39 In our study, participants detailed how social workers guided them through complex labour market regulations, enabling job retention with reduced hours. This approach countered work identity loss and afforded more time for daily life and social engagement- all things essential to a good quality of life. 40 However, bringing well-known and new actors into an interprofessional concept may call for bridging to promote desired outcomes. Effective coordination is vital in interprofessional interventions, 41 with patients suggesting that a care coordinator plays a crucial role in coordinating treatment and care trajectories, acting in provider roles. Ahmad et al. and Lorig et al. assert that effective self-management interventions involve establishing effective condition, role, and emotional management through interprofessional collaboration among healthcare professionals engaged in person-centred care for IMIDs. 24 , 26 Our analysis concurs and adds that having a care coordinator was experienced by patients as offering multiple benefits, including assistance in coordinating their trajectory and recalling crucial details during meetings with clinical professionals, such as navigating treatment plans, various blood tests, and examinations. However, utilising a care coordinator offered crucial existential care by shouldering burdensome responsibilities through trust and providing empathetic companionship in times of hardship. Providing emphatic companionship in care trajectories is well described in nursing literature as a fundamental part of nursing. 42 – 45 The essential role of the care coordinator was underscored as participants highlighted how the coordinator’s support and empathetic companionship were decisive factors in the patients’ acceptance or rejection of referrals to the psychologist, dietician, or social worker. Therefore, we infer that incorporating a care coordinator in new IMIDs interventions, uniting established actors, and expanding interprofessional collaboration can enhance self-management. Nevertheless, we highlight that introducing a care coordinator presents significant dilemmas. First, it should be noted that the building of trust and companionship requires sufficient time. Secondly, it was stated that the goal of the IMIDs intervention was to treat patients and provide them with skills and competencies to self-manage their disease in the future. As Risjord 42 notes, HCPs are obligated to act to the benefit of patients but in ways that respect and promote patient autonomy. 42 Thus, the positive experiences of companionship and relief from significant tasks by having a care coordinator may carry a potential downside, revealing a shift of responsibility from patient to coordinator. Though patients often see care coordinators as essential guides and companions in interventions, there’s a risk of unintentionally shifting responsibilities, potentially hindering the development of crucial self-management skills needed for sustained progress after the intervention. Therefore, future interventions should carefully define the role of the care coordinator to avoid such potential adverse effects. Striking a balance between care coordination, companionship, and self-management support in a patient’s treatment plan is essential to ensure positive outcomes. Limitations This study presents the experiences of IMID patients undergoing an interprofessional intervention. While we assert that the insights in this paper encapsulate the collective experiences of our participants, we acknowledge the complexity and variation in disease patterns within IMIDs. It’s important to recognise that, although not explicitly highlighted in our results, certain experiences may carry more weight in specific diseases than others. This study is built on a qualitative research design aimed at fleshing out insights from the experiential lives of patients. One limitation is that patient interviews were conducted by staff directly involved in the care of patients at the centre. Though patients experience positive outcomes in our study, the paper cannot comment on the broader clinical outcomes related to the disease management of the patients. Such information may be sought in different studies. 6 Future directions Building on patient experiences, we contend that future IMIDs interventions should explore the impact of expanding care teams to include professionals (e.g., psychologists, dieticians, and social workers) with expertise in understanding and alleviating the daily burden of disease experienced in social contexts with family, friends, and co-workers. Future interventions should carefully consider the role of care coordinators. While our study depicts them as professional coordinators and companions deserving of their place in interventions, further exploration is needed to achieve the most effective balance between self-care, shared care, and self-management. We acknowledge that expenses related to interdisciplinary teams may be a limiting factor. It is plausible that the costs associated with a more comprehensive interdisciplinary treatment may result in better-treated patients with an improved understanding of disease, ultimately leading to decreased healthcare costs. However, that is outside the scope of this study. Time is crucial in interprofessional IMIDs interventions. Some patients in the interviews felt that a six-month timeframe might be insufficient for their desired outcomes. Building trust and ensuring effective treatment may require a duration beyond six months, and this raises the critical question: What is the optimal duration for interventions to achieve desired outcomes? This paper does not address this question and should be explored in future research. Conclusions Restructuring healthcare for IMID patients can enhance care quality. Adopting an interprofessional care model bringing well-known and new professionals together may address existing challenges related to fragmented care and offer a more holistic approach. Our results underscore the importance of individualising and tailoring treatment to the needs of each specific patient. The optimal use of interprofessional teams in the care of patients with IMIDs requires careful consideration regarding the specific combinations of diseases, disease burden within each domain, comorbidity burden, disease duration, logistics, economic considerations, and the personal beliefs and preferences of the patient. Ethics The study received ethical approval from the Central Denmark Region Ethical Committee, which is responsible for granting ethical approval to hospital studies in the region where this study was carried out. The trial registration number is NCT04200690. The study was conducted in agreement with the 1964 Helsinki Declaration and its later adjustments and comparable ethical standards. We informed the participants that participation was voluntary. Detailed information regarding the study’s objective and the confidential treatment of participant narratives was provided to all participants verbally and in writing before all interviews. Participants all gave written informed consent. Author contributions statement The study design was conceptualised by LFM, BKN, MDT, GSR, KFH, and LI. Interviews were conducted by LFM, LD, and AA. Participant characteristics were analysed by LFM. Initial analysis was carried out by LFM and MDT, with subsequent discussion and refinement involving BKN, GSR, KFH, and LI. LFM and MDT drafted the manuscript, which was critically revised by BKN, GSR, KFH, and LI. All authors contributed to editing, reviewing, and approving the final manuscript. Declaration of generative AI and AI-assisted technologies in the writing process While preparing this work, the author(s) utilized Grammarly & ChatGPT to enhance language and readability. Subsequently, the author(s) reviewed and edited the content as necessary and take(s) full responsibility for the publication’s content. Data availability statement The datasets analyzed during the current study are not publicly available due to ethical and privacy considerations. The data consists of pseudonymized interview transcripts that contain potentially identifiable information, and complete anonymization is not feasible without compromising the integrity of the data. Interview data may be shared only upon a reasonable request and in a manner that ensures participant confidentiality. Interested researchers may contact the first author to initiate the request. Acknowledgments The authors acknowledge nurse LD as well as sociologist and social worker AA for participating in the study by interviewing patients and helping draft the protocol. Acknowledgment The authors acknowledge nurse Luljeta Deli as well as sociologist and social worker Anja Astrup for participating in the study by interviewing patients and helping draft the protocol. References 1. Bayry J, Radstake TR: Immune-mediated inflammatory diseases: progress in molecular pathogenesis and therapeutic strategies. Expert Rev. Clin. Immunol. 2013; 9 (4): 297–299. Publisher Full Text 2. Haberman R, Perez-Chada LM, Merola JF, et al. : Bridging the Gaps in the Care of Psoriasis and Psoriatic Arthritis: the Role of Combined Clinics. Curr. Rheumatol. Rep. 2018; 20 (12): 76. PubMed Abstract | Publisher Full Text 3. Jansbøl K: Sammenhængende patientforløb – hvad oplever patienter med autoimmune kroniske lidelser, KORA.pdf.2014. 4. 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Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 11 Jul 2025 ADD YOUR COMMENT Comment Author details Author details 1 Department of Dermatology, National Center for Autoimmune Diseases, Aarhus, 8200, Denmark 2 DEFACTUM Public Health Research, DEFACTUM, Central Denmark Region, 8000, Denmark 3 Department of Dermatology, Aarhus University Hospital, Aarhus, 8200, Denmark 4 Department of Dermatology, Aalborg University Hospital, Aalborg, 9000, Denmark 5 Department of Clinical Medicine, Faculty of Health, Aarhus, 8000, Denmark Louise Møller Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Project Administration, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Berit Kjærside Nielsen Roles: Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Gitte Susanne Rasmussen Roles: Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Kasper Fjellhaugen Hjuler Roles: Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Lars Iversen Roles: Writing – Original Draft Preparation, Writing – Review & Editing Morten Deleuran Terkildsen Roles: Conceptualization, Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 11 Jul 2025, 14:686 https://doi.org/10.12688/f1000research.165824.1 Copyright © 2025 Møller L et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Møller L, Nielsen BK, Rasmussen GS et al. Patients perspectives on an interprofessional care model in healthcare for patients with immune-mediated inflammatory diseases: A qualitative study [version 1; peer review: awaiting peer review] . F1000Research 2025, 14 :686 ( https://doi.org/10.12688/f1000research.165824.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: AWAITING PEER REVIEW AWAITING PEER REVIEW ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 11 Jul 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status AWAITING PEER REVIEW Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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