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The effect on spontaneous ventilation was not examined in that study, but propofol has long been known to cause hypoventilation or even apnoea in several animal species including dogs and sheep when given intravenously [ 5 , 6 ]. The evaluation of the first 12 PMHC pilot sites identified a number of implementation challenges that could possibly affect access to and effect of treatment, most notably non-compliance to in- and exclusion criteria, underuse of low-intensity treatments, and lack of focus on return-to-work [ 18 ].