PS08 Exploring the health inequality gap in atopic dermatitis among LGBTQ+ and minority ethnicity communities

Research evidence suggests inequities in access to specialist atopic dermatitis (AD) care for LGBTQ+ and minority ethnicity groups, who can experience poorer outcomes and higher consultation rates with a general practitioner before being referred to a specialist. Understanding of why such inequities exist is limited. The research that exists is largely quantitative and lacks both patient and professional perspectives. This study aimed to address this gap through in-depth exploration of the patient journey and generation of novel insight. We used qualitative methods involving one-to-one interviews and focus groups with members of LGBTQ+ and minority ethnicity groups aged ≥ 18 years and living in the UK with a medical diagnosis of AD. People registered their interest in the study via Voice, a public engagement platform, followed by purposive sampling and selection of 20 patient participants (10 LGBTQ+ and 10 minority ethnic) to maximize diversity and generation of a broad perspective. Five healthcare professionals representing a range of clinical practice were identified from known academic sources, and/or snowball sampling to take part in an interview. Ethical approval and full participant consent were obtained. Interviews and focus groups were conducted remotely via Zoom; they were recorded then transcribed anonymously. Interviews followed a semistructured topic guide covering screening, diagnosis, general views of healthcare professionals, treatment, management and symptoms. Data were analysed thematically and compared for commonalities and differences both across and within groups. To date, 10 interviews have been completed, with six LGBTQ+ participants and four minority ethnic participants (seven female, two male, one nonbinary, one trans-female), age range 24–47 years. Preliminary results suggest that while discrimination-based barriers are not prevalent, the care system can be perceived as lacking empathy and understanding of the patient experience for people living with AD. Participants expressed personal expertise in their condition, with a desire for access to a more holistic approach to AD care that includes preventative measures. However, short consultation times with primary care givers deterred discussion beyond episodic treatment. Participants were unaware of such care options being available through alternative sites of care (pharmacies). This study is ongoing but has already generated deeper insight into the patient journey for people living with AD. Further analysis will illuminate perceived barriers to specialist care for members of LGBTQ+ and minority ethnicity groups and how these might be addressed. The findings will inform general patient-centric recommendations for practice and guide further qualitative work specific to subcommunity needs. Pfizer sponsored and funded this study.